摘要
目的探讨超声引导下粗针穿刺活检术(ultrasound-guided core-needle biopsy,US-CNB)判定甲状腺结节良恶性的效果,以期提高甲状腺结节术前定性诊断的准确率。方法回顾性分析146例经超声诊断为甲状腺结节患者的病例资料,分析采用US-CNB定性诊断甲状腺结节的效果。结果获取的152个结节中,82个结节内可见微钙化。US-CNB诊断恶性肿瘤92个,良性结节56个,4个结节取材不满意。US-CNB诊断假阳性2例(均误诊甲状腺乳头状癌),误诊率3.39%;假阴性3例(均漏诊甲状腺乳头状癌),漏诊率3.23%。US-CNB对直径≥1.0 cm结节的诊断符合率均在97.00%以上,且高于直径<1.0 cm结节的诊断符合率(66.67%),差异有统计学意义(P<0.05)。结论US-CNB对甲状腺结节良恶性的判定有重要意义;通过选择可疑恶性结节穿刺、增加穿刺次数、确保活检针针槽位于结节内、联合细针吸取细胞学检查,可降低US-CNB误诊及漏诊率。
Objective To investigate effect of ultrasound-guided core-needle biopsy （US-CNB） in judgment of benign and malignant thyroid nodules in order to improve accuracy of preoperative qualitative diagnosis of thyroid nodules. Methods Pathological data of 146 patients with thyroid nodules by ultrasound diagnosis was retrospectively analyzed. Effects of qualitative diagnosis by US-CNB for thyroid nodules were analyzed. Results Among obtained 152 nodules, 82 nodes were microcalcification. There were 92 malignant neoplasms, 56 benign nodules and 4 nodules with dissatisfactory materials by USCNB diagnosis. By US-CNB diagnosis, 2 patients were false positive （ misdiagnosed as thyroid papillary carcinoma） , and misdiagnosis rate was 3.39% ; 3 patients were false negative （ missed diagnosis as thyroid papillary carcinoma） , and missed diagnosis rate was 3.23%. Diagnose accordance rate of US-CNB for nodules with diameter equal or more than 1.0 cm was over 97.00% , and the rate was higher than 66.67% in nodules with diameter less than 1.0 cm, and the difference was statistically significant （P 〈 0.05）. Conclusion US-CNB has clinical value in preoperative diagnosis of benign and malignant thyroid nodules. Misdiagnosis and missed rate of US-CNB may be decreased by choosing puncture for suspected malignant thyroid nodules, increasing puncture frequency, confirming groove located in nodules and using combined cytological examination by thin needle suction .
作者
张云山
杨克
付万袭
邱璇
任贺
徐涛
张洁
ZHANG Yun-shan YANG Ke FU Wan-xi QIU Xuan REN He XU Tao ZHANG Jie(Department of Ultrasound Medicine, General Hospital of PLA Navy, Beijing 100048, China)
出处
《临床误诊误治》
2016年第10期40-43,共4页
Clinical Misdiagnosis & Mistherapy
基金
解放军总后勤部重点项目(BHJ14C016)
关键词
超声检查
活组织检查
针吸
甲状腺结节
误诊
漏诊
Uhrasonography
Biopsy, needle
Thyroid nodule
Misdiagnosis
Missed diagnosis
