CEUS与FNA联合在桥本甲状腺炎合并结节良恶性诊断中的价值分析

Analysis of the value of combined CEUS and FNA in the diagnosis of Hashimoto′s thyroiditis with benign and malignant nodules

目的探讨超声造影(CEUS)与细针穿刺细胞学检查(FNA)联合在桥本甲状腺炎合并结节良恶性诊断中的价值。方法回顾性分析我院2017年6月至2020年7月期间收治的桥本甲状腺炎合并结节患者124例(136个结节)术前检查资料,以手术病理检查结果为金标准,对比FNA单独和CEUS与FNA联合对桥本甲状腺炎合并结节良恶性鉴别的价值。结果以手术病理检查结果为金标准,124例患者中共检测出136个肿块,其中甲状腺恶性结节共28个,占28/136(20.59%),甲状腺良性结节共108个,占108/136(79.41%);FNA联合CEUS诊断敏感度(96.43%)、特异度(100.00%)、阳性预测值(100.00%)及阴性预测值(85.71%)均较单独FNA诊断敏感度(92.86%)、特异度(83.33%)、阳性预测值(96.30%)及阴性预测值(71.43%)高(P<0.05),且与金标准检查结果一致性高(Kappa值=0.915,P<0.05)。结论与FNA单独检查相比,CEUS与FNA联合可提高对桥本甲状腺炎合并结节良恶性的诊断价值,值得临床进一步推广。

Objective To explore the value of contrast-enhanced ultrasound(CEUS)and fine-needle aspiration cytology(FNA)in the diagnosis of benign and malignant nodules with Hashimoto′s thyroiditis.Methods The preoperative examination data of 124 patients with Hashimoto′s thyroiditis and nodules(136 nodules)who were admitted to our hospital from June 2017 to July 2020 were retrospectively analyzed.2 There we take the results of surgical pathology as the gold standard,comparing the identification value of FNA alone and CEUS and FNA in the differentiation of Hashimoto,s thyroiditis with nodule benign and malignant.Results Using the surgical pathological examination results as the gold standard,a total of 136 masses were detected in 124 patients,including 28 malignant thyroid nodules,accounting for 28/136(20.59%),and 108 benign thyroid nodules,accounting for 108/136(79.41%);The diagnostic sensitivity(96.43%),specificity(100.00%),positive predictive value(100.00%)and negative predictive value(85.71%)of FNA combined with CEUS are all higher than those of FNA alone(92.86%),The specificity(83.33%),the positive predictive value(96.30%)and the negative predictive value(71.43%)are high(P<0.05),and the results are highly consistent with the gold standard test results(Kappa value=0.915,P<0.05).Conclusion Compared with FNA alone,the combination of CEUS and FNA can improve the diagnostic value of Hashimoto′s thyroiditis with benign and malignant nodules,and is worthy of further clinical promotion.