超声引导下细针穿刺联合超声造影及甲状腺影像报告数据系统分类标准对甲状腺良恶性结节中的诊断价值

Diagnostic value of ultrasound-guided fine needle aspiration combined with contrast-enhanced ultrasonography and TI-RADS classification criteria for benign and malignant thyroid nodules

目的研究超声引导下细针穿刺(US-FNA)联合超声造影(CEUS)及甲状腺影像报告数据系统分类标准对甲状腺良恶性结节中的诊断价值。方法选择2020年1月~2021年6月在海南西部中心医院诊治的110例甲状腺结节患者作为研究对象,共134个结节。所有患者均行US-FNA检查和CEUS检查,比较单独检查和联合检查的结果,对比敏感度、特异性、准确率、阳性预测值及阴性预测值。结果US-FNA检查的敏感度、特异性、准确率、阳性预测值及阴性预测值分别为96.23%、85.71%、94.03%、96.23%和85.71%,CEUS检查为92.45%、42.86%、82.09%、85.96%和60.00%,联合检查为100.00%、28.57%、85.07%、77.94%和100.00%,3种方法的敏感度、准确率、阳性预测值、阴性预测值比较,差异无统计学意义(P>0.05),但US-FNA检查的特异性高于CEUS检查和联合检查(P<0.05)。结论US-FNA检查在甲状腺良恶性结节诊断方面的特异性较高,US-FNA与CEUS联合检查并未有效提高检测的准确率和敏感度。

Objective To explore the diagnostic value of ultrasound-guided fine needle aspiration(US-FNA)combined with contrast-enhanced ultrasonography(CEUS)and TI-RADS classification criteria for thyroid benign and malignant nodules.Methods From January 2020 to June 2021,110 patients with thyroid nodules(totally 134 nodules)in Hainan Western Central Hospital were selected as the research objects.All patients were underwent US-FNA examination and CEUS examination.The results of individual examination and combined examination were compared,and the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were compared.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of US-FNA examination were 96.23%,85.71%,94.03%,96.23%and 85.71%,CEUS examination were 92.45%,42.86%,82.09%.85.96%and 60.00%,the combined inspection were 100.00%,28.57%,85.07%,77.94%and 100.00%.The comparison of the sensitivity,accuracy,positive predictive value,and negative predictive value of the three methods were not statistically significant(P>0.05),but the specificity of US-FNA examination were significantly higher than that of CEUS examination and combined examination(P<0.05).Conclusion The US-FNA examination is highly specific in the diagnosis of benign and malignant thyroid nodules.The combined examination of US-FNA and CEUS has not effectively improved the accuracy and sensitivity of the detection.