剪切波弹性成像对超声引导下甲状腺乳头状癌细针抽吸的定位价值

Value of Shear Wave Elastography in Ultrasound-Guided Fine Needle Aspiration of Papillary Thyroid Carcinoma

目的:探究剪切波弹性成像(SWE)在超声引导下甲状腺乳头状癌的细针抽吸(FNA)定位上的应用价值。方法:对2019年1月至2021年12月期间医院收治90例可疑甲状腺乳头状癌患者相关资料进行回顾性分析,患者均需要在超声引导下进行FNA,依据超声引导使用技术将采用常规二维超声及SWE患者分别纳入常规组(n=42)与SWE组(n=48)。比较两组患者取材结果、穿刺并发症发生率、Bethesda系统病理学分类、良恶性诊断价值。结果:SWE组患者取材成功率与2针检出率均高于常规组,仅2针检出率比较存在统计学意义(P<0.05);SWE组患者穿刺并发症发生率显著低于常规组(4.16%vs21.42%,P<0.05);常规组与SWE组患者Bethesda系统对于病理学分类结果比较没有统计学意义,但是SWE组对Ⅱ~Ⅵ类的检出率高于常规组,差异比较存在统计学意义(P<0.05);以病理结果作为金标准,SWE组患者对恶性病灶诊断灵敏度、准确度均高于常规组,差异存在统计学意义(P<0.05)。结论:SWE有助于帮助可疑甲状腺乳头状癌患者确定FNA位置,提高2针检出率,降低穿刺并发症,可以在一定程度上提高甲状腺乳头状癌诊断价值。

Objective:To investigate the application value of shear wave elastography(SWE)in ultrasound-guided fine needle aspiration(FNA)of papillary thyroid carcinoma.Methods:The relevant data of 90 patients suspected of papillary thyroid carcinoma who were admitted to the hospital from January 2019 to December 2021 were retrospectively analyzed.All patients needed to undergo ultrasound-guided FNA.According to the ultrasound technique used,the patients were divided into conventional group(n=42,two-dimensional ultrasonography)and SWE group(n=48).The sampling results,the incidence of puncture complications,the pathological classification of Bethesda system,and the value in diagnosing benign and malignant lesions were compared between the two methods.Results:The success rate of sampling and the detection rate of 2 needles in the SWE group were higher than those in the conventional group,but only the detection rate of 2 needles showed a statistical significance(P<0.05).The incidence of puncture complications in the SWE group was significantly lower than that in the routine group(4.16%vs 21.42%,P<0.05).The pathological results of Bethesda classification system showed no statistically significant difference between the two groups,but the diagnosis rate of class II~VI in the SWE group was higher than that in the conventional group(P<0.05).With pathological results as the golden standard,the diagnostic sensitivity and accuracy in the SWE group for malignant lesions were higher than those in the conventional group(P<0.05).Conclusion:SWE is helpful for determining the location of FNA in patients suspected of papillary thyroid carcinoma,improving the detection rate of 2 needles,reducing puncture complications,and improving the diagnosis of papillary thyroid carcinoma to a certain extent.