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1、中華醫(yī)學(xué)超聲雜志(電子版)2014年8月第11卷第8期ChinJMed2014,Vo1.11,No.8·介入超聲影像學(xué)·超聲引導(dǎo)下細(xì)針抽吸活檢對(duì)甲狀腺小結(jié)節(jié)的診斷價(jià)值王文涵詹維偉周偉倪曉楓彭艷葉廷軍毛敏靜【摘要】目的探討超聲引導(dǎo)下細(xì)針抽吸活檢對(duì)最大徑≤10mm甲狀腺結(jié)節(jié)的診斷價(jià)值。方法回顧性分析2012年1至12月上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院632例患者654個(gè)最大徑≤10tuna甲狀腺結(jié)節(jié)的超聲引導(dǎo)下細(xì)針抽吸活檢細(xì)胞學(xué)結(jié)果。以手術(shù)病理及臨床隨訪結(jié)果作為金標(biāo)準(zhǔn),評(píng)價(jià)超聲引導(dǎo)下細(xì)針抽吸活檢診斷最大徑≤10i/lrn甲狀腺結(jié)
2、節(jié)的敏感度、特異度、準(zhǔn)確性、陽性預(yù)測值、陰性預(yù)測值。結(jié)果654個(gè)甲狀腺結(jié)節(jié)中,36個(gè)細(xì)胞學(xué)結(jié)果不滿意或無診斷,361個(gè)良性,2個(gè)不典型濾泡性病變,30個(gè)可疑惡性,225個(gè)惡性。排除不滿意與未手術(shù)的不典型濾泡性結(jié)節(jié),余616個(gè)結(jié)節(jié)經(jīng)手術(shù)或臨床隨訪1年以上,最終診斷為惡性259個(gè),良性357個(gè)。超聲引導(dǎo)下細(xì)針抽吸活檢診斷最大徑≤10mm甲狀腺結(jié)節(jié)的敏感度為96.5%,特異度為98.6%,準(zhǔn)確性為97.7%,陽性預(yù)測值為98.0%,陰性預(yù)測值為97.5%。所有患者均未見明顯穿刺后并發(fā)癥。結(jié)論超聲引導(dǎo)下細(xì)針抽吸活檢安全準(zhǔn)確,是鑒別
3、最大徑≤10rn/n甲狀腺結(jié)節(jié)良惡性的重要方法?!娟P(guān)鍵詞】超聲檢查;細(xì)針穿刺活檢;甲狀腺結(jié)節(jié)Thediagnosticvalueofultrasound-guidedfineneedleaspirationbiopsyinsmallthyroidnodulesWangWenhan,ZhanWeiwei,ZhouNiXiaofeng,PengYan,Ye17n~un,MaoMinting.DepartmentofUltrasonography,RuiJinHospital,ShanghaiJiao乃餾University,S
4、choolofMedicine,Shanghai200025,ChinaCorrespondingauthor:ZhanWeiwei,Email."shanghairuifn@126.com[Abstract]0bjectiveToevaluatetheeficacyofultrasound—guidedfineneedleaspirationbiopsy(US-FNAB)inthyroidnodules≤10I/Lrninthemaximumdiameter.MethodsTheUS-FNABresultsof654th
5、yroidnodules≤10mmin632patientswereretrospectivelyanalyzedfromJanuary2012toDecember2012atRuiJinHospita1.Usingpathologyandclinicalcourseasgoldstandard,thesensitivity,specificity,accuracy,positivepredictivevalueandnegativepredictivevalueofUS-FNABwereevaluated.Results
6、Of654nodules,36wereclassifiedasunsatisfactory,361asbenign,2asundetermined,30assuspicious,and225asmalignant.Unsatisfactoryandundeterminednoduleswithoutsurgicaltreatmentwereexcluded.Oftheremaining616nodules,259malignantand357benignnoduleswereeventuaHydiagnosedbysurg
7、eryorclinicalfollow-upformorethanoneyear.Thesensitivity,specificity,accuracy,positivepredictivevalueandnegativepredictivevalueofUS-FNABforthyroidnodules≤10InlTlwere96.5%,98.60/0,97.7%,98.O%and97.5%respectively.Noapparentbiopsy-relatedcomplicationwasfound.Conclusio
8、nUS—FNABisasafeandefectivemethodforthediagnosisofthyroidnodules≤10inlTlinthemaximumdiameter.[Keywords]Ultrasonography;Fineneedleaspirationbiopsy;Thyroid