中国实用外科杂志

中国实用外科杂志

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细针穿刺细胞学检查联合超声造影诊断桥本甲状腺炎合并结节价值研究

马英路1a，黄品同2，王    坤1a，张文晓1a，李保卫1a，杨    智1a，王明辉1a   

  1. 1滨州医学院附属医院  a.甲状腺乳腺外科  b.超声科，山东滨州256603；2浙江大学附属第二医院超声科，浙江杭州310009
  • 出版日期:2019-12-01 发布日期:2019-12-23

  • Online:2019-12-01 Published:2019-12-23

摘要： 目的    探讨细针穿刺细胞学检查（FNA）、超声造影（CEUS）联合应用对桥本甲状腺炎合并结节良恶性诊断价值。方法  回顾性分析滨州医学院附属医院经手术病理学检查证实的桥本甲状腺炎合并甲状腺结节68个，分别以CEUS动脉期早期不均匀低增强，Bethesda报告系统分类大于Ⅳ级作为甲状腺癌的诊断标准，分析FNA、CEUS联合应用的诊断价值。结果    两种方法联合应用与单独使用一种方法比较在敏感度、准确率、阳性预测值、阴性预测值方面差异无统计学意义（P＞0.05），而FNA诊断的特异度均高于CEUS及联合应用，差异有统计学意义（P＜0.05）。结论    FNA对桥本甲状腺炎合并结节良恶性诊断方面具有较高的诊断特异度，CEUS与FNA联合应用并未提高诊断准确率。

关键词: 甲状腺癌, 桥本甲状腺炎, 细针穿刺细胞学检查, 超声造影

Abstract:

Value of fine needle aspiration combined with contrast-enhanced ultrasound in differentiating solid thyroid nodules coexisting Hashimoto’s thyroiditis        MA Ying-lu＊, HUANG Pin-tong, WANG Kun, et al. ＊Department of Thyroid and Breast Surgery, the Binzhou Medical University Hospital, Binzhou 256603, China
Corresponding author: WANG Ming-hui, E-mail:minghuijiayou@126.com
Abstract    Objective    To study the diagnostic efficiency of the fine needle aspiration biopsy (FNA) and contrast-enhanced ultrasound (CEUS) in differentiation of solid thyroid nodules coexisting Hashimoto’s thyroiditis, and to determine whether combined use of both methods is helpful. Methods    A total of 68 thyroid nodules in 62 patients were observed with CEUS and FNA before surgical excision．The diagnostic performances of FNA, CEUS and CEUS combined with FNA were compared. Results    There was no significant difference in sensitivity, accuracy, positive predictive value and negative predictive value among the three methods (P>0.05). The specificity was significant high in FNA group (P<0.05). Conclusion    FNA has high specificity in the diagnosis of Hashimoto's thyroiditis with nodule. FNA combined with CEUS could not improve the diagnostic accuracy for thyroid nodules coexisting Hashimoto’s thyroiditis.

Key words: thyroid carcinoma, Hashimoto’s thyroiditis, fine needle aspiration, contrast-enhanced ultrasound