摘要
目的探讨剪切波弹性成像(SWE)引导细针穿刺对甲状腺良恶性结节的诊断价值。方法选取2018年10月~2019年3月在我院手术的甲状腺结节患者89例(恶性48例,良性41例)。男性26例,女性63例,平均年龄(49±13)岁,对每个结节分别行超声引导下细针穿刺活检(US-FNAB)和SWE引导细针穿刺(SWE-FNAB)。以病理学结果作为金标准,采用Kappa一致性检验分组(≤1cm和>1cm)比较US-FNAB和SWE-FNAB诊断甲状腺癌的差异,并分别计算诊断的敏感性、特异性和准确性。结果与术后病理比较,≤1cm组和>1cm组SWE-FNAB(Kappa=0.853;Kappa=1)与病理的符合率均要高于US-FNAB(Kappa=0.619;Kappa=0.844)。≤1cm组和>1cm组SWE-FNAB诊断甲状腺恶性结节的敏感性、特异性和准确性(96.4%、88.8%、94.6%;100%、100%、100%)均高于US-FNAB(81.8%、87.5%、83.3%;90%、94.4%、92.9%)。结论在≤1cm和>1cm组,SWE-FNAB均较US-FNAB进一步提高细针穿刺的准确性,降低无法诊断率,避免不必要的手术。
Objective To explore the application of shear wave elastography guided fine-needle aspiration biopsy(SWE-FNAB)in the differential diagnosis of thyroid nodules(TNs).Methods From October 2018 to March 2019,87 patients(62 females and 25 males;mean age 49±13 years)with TNs operated in our hospital were enrolled in this study.It was confirmed by operation and pathology that 46 were malignant and 41 were benign.Each of nodules received ultrasound-guided FNAB(US-FNAB)and SWE-FNAB.When compared with pathologic results,TNs were divided into two groups(≤1 cm and>1 cm)based on their size,Kappa statistics,sensitivity,specificity,and accuracy assess the value of US-FNAB and SWE-FNAB in differentiating benign and malignant TNs.Results Compared with the postoperative pathology,in both two groups(≤1 cm and>1 cm),the coincidence rate between SWE-FNAB(Kappa=0.853;Kappa=1)and pathology was higher than that in the US-FNAB(Kappa=0.619;Kappa=0.844).In both two groups(≤1 cm and>1 cm),the sensitivity,specificity and accuracy of SWE-FNAB(96.4%,88.8%,94.6%;100%,100%,100%)in the diagnosis of thyroid malignant nodules were higher than those in the US-FNAB(81.8%,87.5%,83.3%;90%,94.4%,92.9%).Conclusion In both two groups(≤1 cm and>1 cm),SWE-FNAB can further improve the accuracy of fine needle aspiration,comparing to US-FNAB,and reduce the number of undiagnosed results and unnecessary thyroid surgery.
作者
刘辉
胡春峰
LIU Hui;HU Chunfeng(Graduate School of Xuzhou Medical University,Xuzhou 221004,P.R.China;Department of Ultrasonography,Suqian first People's Hospital,Suqian 223800,P.R.China;Department of Radiology,Xuzhou Medical University Affiliated Hospital,Xuzhou 221004,P.R.China)
出处
《医学影像学杂志》
2019年第10期1689-1693,共5页
Journal of Medical Imaging
关键词
甲状腺结节
细针穿刺活检
剪切波弹性成像
病理
超声诊断
Thyroid nodule
Fine-needle aspiration biopsy
Shear wave elastography
Pathology
Ultrasound diagnosis
作者简介
刘辉(1979-),男,江苏宿迁人,毕业于江苏大学,学士学位,现为徐州医科大学研究生院在读医学硕士,副主任医师,主要从事超声诊断工作;通信作者:胡春峰,硕士生导师,主任医师,E-mali:hcfxz@163.com。
