超声检查及引导细针穿刺活检在甲状腺结节良恶性中的鉴别诊断价值

Value of ultrasound and guided fine-needle aspiration biopsy in differential diagnosis of benign and malignant thyroid nodules

目的探讨超声检查及引导细针穿刺活检在甲状腺结节良恶性中的鉴别价值。方法选取148例甲状腺结节患者(共计237个结节),均接受超声引导下细针穿刺活检、常规超声检查,将术后组织病理学诊断结果作为“金标准”,将术前应用的以上两种检查与之进行对照,计算并对比二者鉴别诊断效力及穿刺检查并发症发生情况。结果术后甲状腺组织病理学诊断恶性结节、良性结节比例为183∶54,常规超声诊断恶性、良性比例为171∶66,超声引导下细针穿刺活检诊断恶性、良性比例为182∶55;超声引导下甲状腺细针穿刺活检诊断准确度(97.89%)、灵敏度(98.36%)、特异度(96.30%)较常规超声(78.90%、83.06%、64.81%)更高,P<0.05;148例患者经穿刺检查后均未出现异常疼痛、穿刺点异常出血、皮下血肿等并发症。结论超声引导下甲状腺细针穿刺活检甲状腺结节,可判断结节良恶性性质。

Objective To analyze the significance of ultrasound-guided fine-needle biopsy in the differential diagnosis of benign and malignant thyroid nodules. Methods 148 patients with thyroid nodules(237 nodules in total) in our hospital were set as study samples. All the patients accepted ultrasound guided fine-needle biopsy and conventional ultrasound examination. The results of histopathological diagnosis after surgery were taken as the "gold standard", and the above two examinations applied before surgery were compared with them, the differential diagnostic efficacy and the incidence of puncture complications were calculated and compared. Results After operation, the proportion of malignant and benign nodules diagnosed by thyroid histopathology was 183∶54, the proportion of malignant and benign nodules diagnosed by conventional ultrasound was 171∶66, and the proportion of malignant and benign nodules diagnosed by ultrasound guided fine-needle biopsy was 182∶55;The diagnostic accuracy(97.89%), sensitivity(98.36%) and specificity(96.30%) of ultrasound-guided thyroid fine needle biopsy were higher than those of conventional ultrasound(78.90%, 83.06%, 64.81%)(P<0.05);148 patients had no complications such as abnormal pain, abnormal bleeding at the puncture point, skin blood hematoma, etc. Conclusion Ultrasound guided fine-needle biopsy of the thyroid gland gives a more accurate differential diagnosis of benign and malignant thyroid nodules, which is recommended for clinical use.