Value of contrast-enhanced ultrasound combined with fine needle aspiration biopsy in the diagnosis of thyroid nodules
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摘要:
目的 探讨超声造影结合细针穿刺活检在诊断甲状腺结节方面的临床价值。 方法 观察我院98例甲状腺结节患者的98个结节，每例患者依次进行二维超声检查及超声造影后，再在超声引导下行细针穿刺活检。以手术病理为标准，评价超声造影及细针穿刺活检对甲状腺结节诊断的准确性。 结果 98例甲状腺结节患者，手术病理诊断良性结节40例，恶性结节58例，超声造影及细针穿刺活检诊断甲状腺结节的敏感性、特异性、准确性分别为72%、68%、70%及78%、73%、76%；超声造影结合细针穿刺活检诊断甲状腺结节的敏感性为91%、特异性为90%、准确性为90%，两种检查方法结合可提高甲状腺结节诊断的敏感性、特异性和准确性，差异有统计学意义（P<0.05）。 结论 超声造影结合细针穿刺活检可在术前更准确、更安全的判断甲状腺结节的良恶性，对甲状腺结节的诊断具有重要的临床意义。 Abstract:Objective To study the clinical application value of contrast-enhanced ultrasound combined with fine needle aspiration biopsy in the diagnosis of thyroid nodules. Methods Ninety-eight thyroid nodules from 98 patients in our hospital were observed. Patients were performed with the examination of two-dimensional ultrasound and contrast-enhanced ultrasound.Then they accepted fine needle aspiration biopsy under ultrasound guidance. According to surgical pathology, the accuracy of contrast-enhanced ultrasound and fine needle aspiration biopsy in the diagnosis of thyroid nodules were evaluated. Results In 98 cases of thyroid nodules, 40 cases were surgical pathologic diagnosis of benign nodules, 58 cases of malignant nodules. The sensitivity, specificity and accuracy of contrast-enhanced ultrasound and fine needle aspiration in diagnosis of thyroid nodules were 72%, 68%, 70% and 78%, 73%, 76%. Contrast-enhanced ultrasound combined with fine needle biopsy in the diagnosis of thyroid nodules got the sensitivity of 91%, specificity of 90%, accuracy of 90%. The sensitivity specificity and accuracy of thyroid nodule diagnosis were significantly improved by combination of two methods of examination, and the difference was statistically significant（P<0.05）. Conclusion Contrast-enhanced ultrasound combined with fine needle aspiration biopsy can be accurate and safe to judge benign and malignant thyroid nodules.It has important clinical significance for the diagnosis of thyroid nodule. -
Key words:
- contrast-enhanced ultrasound /
- fine needle aspiration /
- thyroid nodules
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表 1 超声造影、细针穿刺活检及超声造影结合细针穿刺活检诊断甲状腺结节敏感性、特异性、准确性的比较（n，%）
检查方法 敏感性 特异性 准确性 超声造影 72（42/58） 68（27/40） 70（69/98） 细针穿刺活检 78（45/58）a 73（29/40）a 76（74/98）a 超声造影结合细针穿刺活检 91（53/58）bc 90（36/40）bc 90（88/98）bc χ2 7.092 6.242 11.758 P 0.029 0.044 0.003 aP>0.05vs超声造影; bP<0.05vs超声造影; cP<0.05vs细针穿刺活检. 
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