常规超声及弹性成像引导下甲状腺结节细针穿刺活检对C-TI-RADS4类结节的诊断价值

doi:10.3969/j.issn.1006-6233.2023.05.016

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摘要 目的:探讨常规超声及弹性成像应变率比引导下甲状腺结节细针穿刺活检对C-TI-RADS4类结节的诊断价值。方法:回顾分析2019年6月至2021年12月于承医附院已行甲状腺结节手术切除术的141例共141个结节患者,所有结节均为C-TI-RADS4类,全部结节行常规超声及弹性成像应变率比引导下甲状腺细针穿刺活检术(US-FNAB、E-US-FNAB),获得细胞病理学结果,最终与术后组织病理学结果对照,分析常规超声及弹性成像引导下甲状腺结节细针穿刺活检对C-TI-RADS4类结节的诊断价值。结果:141个C-TI-RADS4类甲状腺结节,常规超声引导下甲状腺结节细针穿刺活检的灵敏度、特异度、准确率、阳性及阴性预测值分别为86.5%、86.7%、86.5%、96%、63.4%;弹性成像引导下甲状腺结节细针穿刺活检的灵敏度、特异度、准确率、阳性及阴性预测值分别为96.4%、86.7%、94.3%、96.4%、86.7%。两者的灵敏度、准确率及阴性预测值之间差异有统计学意义(χ²=6.964、χ²=4.956、χ²=4.779,P<0.05);两者诊断的特异度及阳性预测值之间差异无统计学意义(χ²=0.000、χ²=0.000,P>0.05)。结论:超声弹性成像应变率比引导下甲状腺结节细针穿刺活检对C-TI-RADS4结节诊断有一定的临床价值。

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关键词 ：超声, 弹性成像应变率比引导, 穿刺活检, 甲状腺结节, C-TI-RADS 4类

Abstract：Objective: To investigate the diagnostic value of fine needle aspiration biopsy of thyroid nodules guided by conventional ultrasound and elastography for C-TI-RADS4 nodules.Methods:A total of 141 patients with 141 nodules who had undergone surgical resection of thyroid nodules from June 2019 to December 2021 at our hospital were retrospectively analyzed, and all nodules were classified as C-TI-RADS4. All nodules were subjected to conventional ultrasound and elastography strain-rate ratio-guided fine needle aspiration biopsy of the thyroid gland (US-FNAB, E-US-FNAB) to obtain cytopathological results, which were eventually compared with postoperative histopathological results to analyze the diagnostic value of conventional ultrasound and elastography-guided fine needle aspiration biopsy of thyroid nodules for C-TI-RADS4 category nodules.Results: For 141 C-TI-RADS4 category thyroid nodules, the sensitivity, specificity, accuracy, positive and negative predictive values of conventional ultrasound-guided fine-needle aspiration biopsy of thyroid nodules were 86.5%, 86.7%, 86.5%, 96%, and 63.4%, respectively; the sensitivity, specificity, accuracy, positive and negative predictive values of elastography-guided fine-needle aspiration biopsy of thyroid nodules were 96.4%, 86.7%, 94.3%, 96.4%, and 86.7%, respectively. The differences between the sensitivity, accuracy and negative predictive values were statistically significant (χ²=6.964, χ²=4.956, χ²=4.779, P<0.05); the differences between the specificity and positive predictive values of the two diagnoses were not statistically significant (χ²=0.000, χ²=0.000, P>0.05).Conclusion: Ultrasound elastography guided fine needle aspiration biopsy of thyroid nodule has certain clinical value in the diagnosis of C-TI-RADS4 nodule.

Key words： Ultrasound Elastography guide Thyroid nodule Needle biopsy C-TI - RADS4 class

基金资助:河北省承德市科技研究与发展计划项目,(编号:202006A044)

通讯作者: 那磊

引用本文:

丁华杰, 那磊, 龚雪, 李莎, 史华宁. 常规超声及弹性成像引导下甲状腺结节细针穿刺活检对C-TI-RADS4类结节的诊断价值[J]. 河北医学, 2023, 29(5): 782-785.
DING Huajie, NA Lei, GONG Xue, et al. Diagnostic Value of Fine Needle Aspiration Biopsy of Thyroid Nodules Guided by Conventional Ultrasound and Elastography for C-TI-RADS4 Nodules. HeBei Med, 2023, 29(5): 782-785.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.05.016 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I5/782