甲状腺结节硬度对粗、细针穿刺活检标本满意度的影响

Effect of the hardness of thyroid nodules on sample satisfaction of core needle biopsy and fine needle aspiration

目的:探究甲状腺结节的硬度是否影响超声引导下粗、细针穿刺标本的满意度,从而选择最佳的穿刺方案。方法:回顾分析164例在超声引导下行甲状腺结节穿刺的患者资料,共164个结节,分组的前提条件为结节大小0.8~2.0 cm,过小或过大结节都不列入研究组中,依据甲状腺结节超声弹性成像(UE)形变率值,分为A(0~10%)、B(>10%~20%)、C(>20%)3组,按穿刺针粗、细分为6个小组,粗针组为A1、B1、C1,细针组为A2、B2、C2。细针穿刺活检标本满意度依据Bethesda标准,粗针穿刺取材满意度依据肉眼观察。结果:164个结节行超声引导下粗、细针穿刺活检,总体标本满意度粗针组为84.76%,细针组为63.41%。标本满意度:A1组为84.62%,A2组为64.10%;B1组为80.43%,B2组为52.17%;C1组为90.00%,C2组:75.00%。A1组与A2组、B1组与B2组比较标本满意度差异有统计学意义(P<0.05),C1组与C2组标本满意度差异无统计学意义(P>0.05)。结论:甲状腺结节的硬度在一定条件下可影响穿刺标本的满意度,结合UE结果,可明确评估甲状腺结节的硬度,有助于指导选取最佳穿刺方案,从而提高穿刺标本满意度。

Objective:To explore whether the hardness of thyroid nodule could affect the satisfaction of ultrasound-guided coarse and fine needle puncture,so as to choose the best puncture scheme.Method:Clinical data of 164 patients(164 nodes)undergoing ultrasound-guided thyroid nodule biopsy were collected.The conditions for selecting research objects were the nodules size ranging from 0.8 to 2.0 cm.The subjects were divided into group A(0-10%),group B(>10%-20%)and group C(>20%)according to the deformation rate of ultrasound elastography(UE).The sample satisfaction of Fine needle aspiration was based on the Bethesda classification,the sample satisfaction of core needle was based on visual observation.Result:Ultrasound-guided core and fine needle biopsy were performed on 164 nodules.the satisfaction of specimens of overall is 84.76%by the coarse needle and 63.41%by the fine needle.The satisfaction of specimens of groups in A1 group:84.62%,A2 group:64.10%,B1 group:80.43%,B2 group:52.17%,C1 group:90.00%,C2 group:75.00%,respectively.The differences of specimen satisfaction are statistically significant between A1 and A2 groups,and between B1 and B2 groups(P<0.05,respectively).but not statistically significant between C1 and C2 groups(P>0.05).Conclusion:The hardness of thyroid nodule can affect the satisfaction of puncture specimens under certain conditions.Combining with the results of ultrasound elastography,the clear assessment of the hardness of thyroid nodule can help to guide the selection of the best puncture scheme,so as to improve the satisfaction of puncture specimens.