甲状腺肿物超声、CT与超声引导下穿刺活检结果对照分析

Comparative Analysis of Diagnostic Results of Ultrasound,CT and Pathological Results of Ultrasound-guided Aspiration Biopsy

目的对甲状腺肿物超声、CT及超声引导下穿刺活检(US-FNAB)诊断结果进行对照分析。方法收集2017年1月-2018年12月就诊于医院并经手术病理明确诊断的甲状腺肿物患者96例,术前均行超声、CT及US-FNAB检查,将超声、CT及US-FNAB检查结果与手术病理结果进行对照分析。结果96例患者,手术病理证实甲状腺乳癌33例,结节性甲状腺肿59例,腺瘤4例。以手术病理结果为金标准,超声诊断的敏感度为77.1%,特异度为80.3%,准确度为79.2%;CT诊断的敏感度为68.6%,特异度为75.4%,准确度为72.9%;二者诊断的敏感度、特异度、准确度对比均无统计学差异(P>0.05)。US-FNAB检查诊断的敏感度、特异度、准确度分别为94.3%、100.0%、97.9%,均明显高于超声及CT检查(P<0.05)。结论超声或CT均有助于甲状腺肿物的早期筛查,但其诊断准确度较低;而US-FNAB检查诊断的准确度较高,可在术前明确病理诊断。

Objective To give comparative analysis of diagnostic results of ultrasound,CT and ultrasound-guided fine-needle aspiration biopsy(US-FNAB)of thyroid masses.Methods 96 patients who were treated in our hospital from January 2017 to December 2018 and were diagnosed as thyroid masses confirmed by surgical pathology were collected,and they were given ultrasound,CT and US-FNAB before operation.The diagnostic results of ultrasound,CT and US-FNAB were compared with the results of surgical pathology.Results Among the 96 patients,there were 33 cases of thyroid breast cancer,59 cases of nodular goiters and 4 cases of adenomas confirmed by surgical pathology.The surgical pathological results were taken as the gold standards,and the sensitivity,specificity and accuracy of ultrasound diagnosis were 77.1%,80.3%and 79.2%.The sensitivity,specificity and accuracy of CT diagnosis were 68.6%,75.4%and 72.9%.There were no significant differences in the sensitivity,specificity and accuracy between the two diagnoses(P>0.05).The sensitivity,specificity,and accuracy of US-FNAB examination were 94.3%,100.0%and 97.9%respectively,which were significantly higher than those of ultrasound or CT(P<0.05).Conclusion Ultrasound or CT is helpful for early screening of thyroid masses,but it has low diagnostic accuracy.US-FNAB has high accuracy,and it can confirm pathological diagnosis before operation.