超声弹性成像联合细针穿刺活检在甲状腺结节鉴别诊断中的应用价值

Application value of ultrasound elastography combined with fine needle aspiration in the differential diagnosis of thyroid nodules

目的探讨超声弹性成像联合细针穿刺活检(FNA)在甲状腺结节鉴别诊断中的应用价值。方法选取2020年2月至2021年6月于萍乡市人民医院就诊的82例甲状腺结节患者作为研究对象,所有患者均行FNA和超声弹性检查,以病理学检查结果为金标准,比较不同检查用于鉴别良恶性甲状腺结节的超声特征及诊断价值。结果病理学检查结果显示,82例甲状腺结节患者共90个结节,其中良性结节28个,恶性结节62个;FNA诊断良性结节32个,恶性结节55个,不确定结节3个;超声弹性成像联合FNA诊断良性结节30个,恶性结节60个;良恶性甲状腺结节的形态、结节回声类型、结节内回声、后方回声衰减情况、边界情况、钙化情况、纵横比及阻力指数(RI)比较差异有统计学意义(P<0.05);良恶性甲状腺结节的血流情况比较差异无统计学意义。超声弹性成像联合FNA诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值均明显高于FNA,差异有统计学意义(P<0.05)。结论两种检查方法对鉴别甲状腺结节的良恶性均具有一定诊断价值,但超声弹性成像联合FNA诊断甲状腺良恶性结节的诊断效能更高。

Objective To investigate the application value of ultrasound elastography combined with fine needle aspiration(FNA)in the differen-tial diagnosis of thyroid nodules.Methods A total of 82 patients with thyroid nodules who were treated at Pingxiang People's Hospital from Febru-ary 2020 to June 2021 were selected as the study subjects,all patients received FNA and ultrasound elastography,with pathological results as the gold standard,the value of different examinations in differential diagnosis of benign and malignant thyroid nodules was compared.Results Patho-logical results showed that there were 90 nodules in 82 patients,including 28 benign nodules and 62 malignant nodules;FNA diagnosed 32 benign nodules,55 malignant nodulesand 3 uncertain nodules;ultrasound elastography combined with FNA diagnosed 30 benign nodules and 60 malignant nodules.There were statistically significant differences between benign and malignant thyroid nodulesin terms of morphology,echo type,echo innod-ule,posterior echo attenuation,boundary,calcification,aspect ratio,and resistance index(RI)(P<0.05),but there was no statistically significant dif-ference in blood flow.The diagnostic sensitivity,specificity,accuracy,positive and negative predictive values of ultrasound elastography combined with FNA were significantly higher than those of FNA,the differences were statistically significant(P<0.05).Conclusion Both examination meth-ods can be used for differential diagnosis of benign and malignant thyroid nodules,ultrasound elastography combined with FNA is more efficient in diagnosing benign and malignant thyroid nodules.