摘要
目的分析超声造影(CEUS)、 MSCT及细针穿刺(FNAC)在甲状腺结节良 恶性病变诊断中的应用价值。方法 选取 2016年7月至2017年11月我院收治的甲状 腺病变患者90例(95个结节),其中病理检 查证实为良性结节40个,恶性结节55个, 均采用CEUS、MSCT、FNAC检查,分析三种 检查方法下各影像特征,并评估CEUS、 MSCT、FNAC的诊断效能。结果 CEUS、 MSCT下甲状腺良恶性结节均有其特征性 影像学表现;FNAC诊断甲状腺结节恶性 病变的特异度、准确度、阳性预测值、 阴性预测值高于CEUS、MSCT,而CEUS、 MSCT、FNAC三者联合检测诊断甲状腺结节 恶性病变的灵敏度、特异度、准确度、阳 性预测值、阴性预测值高于单项检测(P <0.05)。结论 CEUS、MSCT、FNAC在甲 状腺良恶性病变中有较高诊断价值,尤其 是FNAC有较高的特异度、准确度,三者联 合检测有助于提高诊断效能,值得在临床 推广应用。
Objective To analyze the value of contrast-enhanced ultrasonography (CEUS), MSCT and fine needle aspiration cytology (FNAC) in the diagnosis of benign and malignant thyroid nodules. Methods 90 patients (95 nodules) with thyroid disease who were admitted to the hospital from July 2016 to November 2017 were studied. Among them, 40 benign nodules and 55 malignant nodules were confirmed by pathological examination. All of them were examined by CEUS, MSCT and FNAC. The imaging features of the three methods were analyzed, and the diagnostic efficiencies of CEUS, MSCT and FNAC were evaluated. Results Imaging findings of both CEUS and MSCT for benign thyroid nodules were characteristic. The specificity, accuracy, positive predictive value and negative predictive value of FNAC for the diagnosis of thyroid nodules were higher than those of CEUS or MSCT. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of combined detection of CEUS, MSCT and FNAC were higher than those of single detection (P<0.05). Conclusion CEUS, MSCT and FNAC are of high diagnostic value for benign and malignant thyroid lesions. The specificity and accuracy of FNAC are high. The combined detection of the three is helpful to improve the diagnostic efficiency.
【关键词】超声造影;MSCT;细针穿刺; 甲状腺结节;良恶性病变
【中图分类号】R736.1;R445.1;R445.3
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.08.012
前言
甲状腺结节为一种常见内分泌疾病,恶性率约为5%~15%,准确 评估其良恶性有重要意义[1-2]。超声造影(CEUS)通过静脉注入微泡显 示肿块微血管以诊断甲状腺结节的良恶性,而超声造影下细针穿刺 (FNAC)也是诊断甲状腺结节的常用方法,有操作简便、安全、痛苦小 等优点,有研究[3]显示CEUS结合FNAC对诊断甲状腺结节良恶性有较高 价值,CEUS对FNAC起着一定辅佐作用。但超声检查时可能存在影像 重叠现象,造成误诊漏诊,而MSCT具有较好的密度分辨率、空间分辨 率[4]。本研究主要分析CEUS、MSCT、FNAC在甲状腺良恶性结节诊断中 的应用价值,结果报告如下。
中国CT和MRI杂志
第16卷, 第 8 期
2018年08月
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