高频超声联合FNA穿刺时针感对甲状腺结节的诊断价值

Diagnostic Value of High Frequency Ultrasound Combined with Sensation of FNA in Benign and Malignant Thyroid Nodules

目的探讨高频超声联合细针穿刺抽吸(fine needle aspiration,FNA)穿刺时针感对甲状腺良恶性结节的诊断价值.方法选择2019年2月-2019年3月于超声科就诊患者300例(共计326个结节).平均年龄(48.0±4.2)岁(年龄范围19~81岁),男性81例,女性219例.所有结节均进行FNA检查.记录穿刺时针感,联合穿刺针感对所有结节评分(良性:1分,可疑良性:2分,可疑恶性:3分,恶性:4分).其中152例结节进行手术治疗,以术后病理为金标准.结果FNA组:1分27例(8.03%)、2分34例(10.42%)、3分28例(8.59%)、4分237例(72.70%);手术组:1分5例(3.29%)、2分8例(5.26%)、3分13例(8.55%)、4分126例(82.89%).手术组中最终病理证实良性7例(4.61%),恶性145例(95.39%).手术组诊断的敏感性、特异性、准确度、阳性预测值、阴性预测值分别为93.10%、42.86%、90.79%、97.12%、23.08%.结论高频超声联合穿刺针感在评估甲状腺结节良恶性方面有一定的诊断价值.

Objective To evaluate the diagnostic value of high frequency ultrasound combined with sensation of fine needle aspiration(FNA)in patients with thyroid nodules.Methods From February 2019 to March 2019,300 patients(a total of 326 nodules)were enrolled,including 81 cases of males and 219 cases of females.These patients had mean age of(48.0±4.2)years old(range:19-81 years).All patients received FNA examinations.Recorded the sensation of FNA and the diagnostic score:1=possible benign,2=benign,3=possible malignant,4=malignant.Finally,a total of 152 thyroid lesions received surgical resection.The diagnostic performance of radiologist was analyzed.Results The diagnostic confidence scoring of lesions by radiologists between the group of FNA and the group of surgical resection was 1-score(8.03%vs 3.29%),2-score(10.42%vs 5.26%),3-score(8.59%vs 8.55%),4-score(72.70%vs 82.89%).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ultrasound in the diagnosis of thyroid nodules were 93.10%,42.86%,90.79%,97.12%,23.08%.Conclusion The sensation of FNA would provide specific information and help to differentiate thyroid benign lesion from carcinoma.