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超声引导下细针抽吸活检与超声造影在不同大小甲状腺结节中的价值比较。

Comparison of the value of ultrasound-guided fine needle aspiration biopsy and contrast-enhanced ultrasound in different sizes of thyroid nodules.

机构信息

Department of Thyroid and Breast Surgery, Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.

Department of Thyroid and Breast Surgery, Yichang Central People's Hospital, Yichang, Hubei, China.

出版信息

Medicine (Baltimore). 2024 Sep 27;103(39):e39843. doi: 10.1097/MD.0000000000039843.

Abstract

The purpose of this study was to evaluate the diagnostic value of ultrasound-guided fine needle aspiration biopsy (US-FNAB) and contrast-enhanced ultrasound (CEUS) in the presence of thyroid nodules of different sizes. We retrospectively analyzed 110 patients with surgically operated unimodular thyroid nodules in Yichang City Central Hospital from July 1, 2021, to April 1, 2023, all of whom underwent conventional thyroid ultrasound, CEUS, and US-FNAB, and all of whom were classified according to the size of nodules into <0.5, 0.5 to 1, and ≥1 cm groups. The diagnostic accuracy, sensitivity, and specificity of the 2 methods for benign and malignant nodules were calculated. Among 110 thyroid nodules, 102 were malignant nodules and 8 were benign nodules. In patients with nodule diameters <1 cm the sensitivity of US-FNAB and CEUS was 87.02% and 93.89%, respectively, and the specificity was 100.00% and 66.67%, with an accuracy of 87.31% and 93.28%, respectively. In patients with nodule diameter <0.5 cm, the sensitivities of US-FNAB and CEUS were 74.29% and 100.00%, respectively, and the differences were statistically significant (P < 0.05); in patients with nodule diameter 0.5 to 1 cm, the sensitivities of US-FNAB and CEUS were 79.59% and 95.92%, respectively, and the differences were statistically significant (P < 0.05); among patients with nodule diameters ≥1 cm, the sensitivities of US-FNAB and CEUS were 88.89% and 77.78%, respectively, with no statistically significant difference (P > 0.05). For thyroid nodules ≤1 cm in diameter, the sensitivity of CEUS examination was higher than that of US-FNAB; and CEUS still has good diagnostic accuracy in the diagnosis of benign and malignant thyroid nodules <0.5 cm, CEUS is recommended for thyroid nodules diagnosed negatively by US-FNAB with a diameter of <1 cm; and CEUS should be preferred for thyroid nodules with a diameter of <0.5 cm. CEUS should be preferred for thyroid nodules <0.5 cm in diameter.

摘要

本研究旨在评估超声引导下细针抽吸活检(US-FNAB)和超声造影(CEUS)在不同大小甲状腺结节中的诊断价值。我们回顾性分析了 2021 年 7 月 1 日至 2023 年 4 月 1 日在宜昌市中心医院接受手术治疗的 110 例单发性甲状腺结节患者的临床资料,所有患者均接受了常规甲状腺超声、CEUS 和 US-FNAB 检查,并根据结节大小分为<0.5cm、0.51cm 和≥1cm 组。计算两种方法对良恶性结节的诊断准确性、灵敏度和特异性。在 110 个甲状腺结节中,102 个为恶性结节,8 个为良性结节。结节直径<1cm 的患者中,US-FNAB 和 CEUS 的灵敏度分别为 87.02%和 93.89%,特异性分别为 100.00%和 66.67%,准确性分别为 87.31%和 93.28%。结节直径<0.5cm 的患者中,US-FNAB 和 CEUS 的灵敏度分别为 74.29%和 100.00%,差异有统计学意义(P<0.05);结节直径 0.51cm 的患者中,US-FNAB 和 CEUS 的灵敏度分别为 79.59%和 95.92%,差异有统计学意义(P<0.05);结节直径≥1cm 的患者中,US-FNAB 和 CEUS 的灵敏度分别为 88.89%和 77.78%,差异无统计学意义(P>0.05)。对于直径≤1cm 的甲状腺结节,CEUS 检查的灵敏度高于 US-FNAB;CEUS 对直径<0.5cm 的良性和恶性甲状腺结节仍具有良好的诊断准确性,建议对直径<1cm、US-FNAB 检查结果为阴性的甲状腺结节进行 CEUS 检查;对于直径<0.5cm 的甲状腺结节,建议首选 CEUS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b134/11441858/e68ec0682b3a/medi-103-e39843-g001.jpg

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