超声引导下穿刺活检联合超声造影在甲状腺结节良恶性诊断中的价值

The value of ultrasound guided needle biopsy combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant thyroid nodules

目的探索超声引导下穿刺活检联合超声造影在甲状腺结节良恶性诊断中的价值。方法回顾性分析于2019年6月至2021年12月在本院行因各种原因行甲状腺结节切除术的患者66例的资料。所有患者均接受术前甲状腺超声造影、穿刺活检。以术中冰冻切片作为金标准,分别比较超声造影和穿刺活检的特异度、灵敏度和曲线下面积。以术中冰冻病理切片为金标准,将患者分为恶性组和良性组,比较两组患者的超声造影的影像学特征及差异。结果66例患者共计检出87个甲状腺结节,含21例恶性(29个结节),45例良性(58个结节)。超声造影的特异度和灵敏度分别为68.97%(40/58)和72.41%(21/29);穿刺活检的特异度和灵敏度分别为81.03%(47/58)和82.76%(24/29);两者联合的特异度和灵敏度分别为94.83%(55/58)和96.55%(28/29)。各项检查方式之间的灵敏度和特异度差异均显著,P<0.05。良性结节和恶性结节的造影结果也存在显著差异(P<0.05)。结论超声引导下穿刺活检联合超声造影对甲状腺结节良恶性鉴别诊断的价值较高,值得临床推广。

Objective To explore the value of ultrasound guided needle biopsy combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant thyroid nodules.Methods The data of 66 patients who underwent thyroid nodulectomy from June 2019 to December 2021 in our hospital were retrospectively analyzed.All patients underwent preoperative contrast-enhanced ultrasound and needle biopsy of the thyroid gland.Using intraoperative pathological examination as the gold standard,the specificity,sensitivity,and area under curve of contrast-enhanced ultrasound and needle biopsy were compared.Using intraoperative pathological examination as the gold standard,the patients were divided into malignant and benign groups,and the imaging characteristics and differences of contrast-enhanced ultrasound between the two groups were compared.Results A total of 87 thyroid nodules were detected in 66 patients,including 21 malignant(29 nodules)and 45 benign(58 nodules).The specificity and sensitivity of contrast-enhanced ultrasound were 68.97%(40/58)and 72.41%(21/29),respectively.The specificity and sensitivity of needle biopsy were 81.03%(47/58)and 82.76%(24/29),respectively.The specificity and sensitivity of the combination were 94.83%(55/58)and 96.55%(28/29),respectively.The sensitivity and specificity of each examination method were significantly different(P<0.05).There was also a significant difference in the imaging results between benign and malignant nodules(P<0.05).Conclusion Ultrasound guided needle biopsy combined with contrast-enhanced ultrasound has a high value in the differential diagnosis of benign and malignant thyroid nodules,which is worthy of clinical using.