余璐璐,刘丽萍.重复超声引导下细针穿刺活检术诊断BethesdaⅠ/Ⅲ类甲状腺结节[J].中国医学影像技术,2021,37(9):1312~1316
重复超声引导下细针穿刺活检术诊断BethesdaⅠ/Ⅲ类甲状腺结节
Repeated ultrasound-guided fine needle biopsy for diagnosis of Bethesda Ⅰ/Ⅲ type thyroid nodules
投稿时间:2020-10-29  修订日期:2021-06-11
DOI:10.13929/j.issn.1003-3289.2021.09.008
中文关键词:  甲状腺结节  活组织检查,针吸  超声检查
英文关键词:thyroid nodule  biopsy, needle  ultrasonography
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作者单位E-mail
余璐璐 重庆医科大学附属第一医院超声科, 重庆 400010  
刘丽萍 重庆医科大学附属第一医院超声科, 重庆 400010 liuliping197404@163.com 
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中文摘要:
      目的 评价重复超声引导下细针穿刺活检术(US-FNAB)对于初次US-FNAB结果为BethesdaⅠ/Ⅲ类甲状腺结节的诊断价值。方法 81例患者经初次US-FNAB检出84个结节BethesdaⅠ/Ⅲ类,对其行重复US-FNAB,比较标本满意率、诊断明确率及诊断类别差异,并据以分为明确组(n=49)和不明确组(n=35);根据手术及超声随访结果,排除1个无法明确判断结节后,将83个诊断明确结节又分为良性组(n=50)和恶性组(n=33);比较各组结节大小、变化及超声征象等差异。结果 重复US-FNAB对80个结节(80/84,95.24%)取材满意,49个(49/84,58.33%)得出明确诊断;其对初次结果为BethesdaⅠ类与Ⅲ类结节的标本满意率、诊断明确率及诊断类别差异无统计学意义(P均>0.05)。明确组与不明确组间仅甲状腺影像报告和数据系统(TI-RADS)分类差异具有统计学意义(P<0.05);良性组与恶性组结节回声、大小变化、纵横比、边界及TI-RADS分类差异均具有统计学意义(P均<0.05)。结论 重复US-FNAB对明确诊断和临床管理BethesdaⅠ/Ⅲ类甲状腺结节具有重要价值;对纵横比>1、边界不清、回声低、大小变化及TI-RADS类别较高的结节应行重复US-FNAB。
英文摘要:
      Objective To observe the value of repeated ultrasound-guided fine-needle aspiration biopsy (US-FNAB) for diagnosis of initial US-FNAB results as Bethesda Ⅰ/Ⅲ type thyroid nodules. Methods Eighty-one patients with 84 initial US-FNAB diagnosed Bethesda Ⅰ/Ⅲ type thyroid nodules underwent repeated US-FNAB. The specimen satisfaction rate, diagnostic accuracy rate and diagnostic category of repeated US-FNAB were compared between Ⅰ/Ⅲ type nodules. Then the nodules were divided into definite group (n=49) and ambiguous group (n=35) according to repeated US-FNAB, as well as benign group (n=50) and malignant group (n=33) according to the outcomes of surgical resection or ultrasound following-up after excluding of 1 nodule since ambiguous estimation. The sizes, changes and ultrasonic manifestations of the nodules were compared between different groups. Results Satisfactory samples were obtained in repeated US-FNAB of 80 (80/84,95.24%), while definite diagnosis was obtained in 49 (49/84,58.33%) nodules. There was no statistical significance of specimen satisfaction rate, diagnostic accuracy rate nor diagnostic category of repeated US-FNAB between initial US-FNAB diagnosed Bethesda Ⅰ and Ⅲ type nodules (all P>0.05). After repeated US-FNAB, significant difference was found only of the thyroid imaging reporting and data system (TI-RADS) type between definite group and ambiguous group (P<0.05). There were significant differences of the echo, size, aspect ratio, boundary and TI-RADS type between benign group and malignant group (all P<0.05). Conclusion Repeated US-FNAB was of great value for definite diagnosis and clinical management of Bethesda Ⅰ/Ⅲ type thyroid nodules, which was recommended for nodules with the aspect ratio>1, ill-defined boundaries, low echo, size variation and high TI-RADS types.
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