| 摘要: |
| 目的 探讨甲状腺超声联合细针抽吸细胞学检查（FNAC）对Bethesda（甲状腺细胞病理学贝塞斯达系统）Ⅰ-V类结节的诊断价值。 方法 回顾性分析65例甲状腺结节患者（共65个结节）术前FNAC资料，统计结节微钙化、边界不清、结节呈低回声、纵横比及结节周围声晕声学特征参数，分析上述参数诊断甲状腺结节的敏感性和特异性，绘制阳性超声参数预测结节的ROC曲线并计算AUC面积，确定最佳诊断界点，评估其诊断价值。结果 甲状腺结节超声诊断价值和阳性超声参数个数有关，满足0、1、2、3、4、5项超声参数的恶性率分别是12.50%、46.67%、66.67%、81.82%、88.89%及100%；边界不清和纵横比具有更好的诊断价值，其阳性预测值分别为90.0%和90.0%；结节大小不是良恶性的较好分辨指标，其阳性预测值仅为39.13%。阳性超声参数预测结节恶性率的ROC曲线的曲线下面积为0.819，以具有2个以上阳性超声参数为恶性结节的诊断标准。超声联合FANC对恶性结节诊断的敏感性为75.00%，特异性为75.90%。 结论 超声联合FANC可以提高对甲状腺结节的恶性预测，有助于减少诊断性手术和过度治疗。 |
| 关键词: 超声 甲状腺 结节 Bethesda FNAC |
| DOI： |
| 投稿时间：2017-03-30修订日期：2017-10-09 |
| 基金项目: |
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| The value of ultrasound combined with FNAC in the diagnosis of thyroid nodules |
| Liuhui |
| () |
| Abstract: |
| ABSTRACT Objective To investigate the risk of thyroid malignancy in patients evaluated as Bethesda I-V by thyroid ultrasound combined Fine needle aspiration cytology of thyroid (FANC). Methods Sixty-five patients were retrospectively analyzed with thyroid nodules as Bethesda I-V by preoperative FNAC in September 2015 to March 2016.The sensitivity and specificity of the parameters，such as nodules microcalcification，obscure boundary，hypoechoic nodules，aspect ratio and Acoustic halo and acoustic characteristics，were detected.Area of the AUC was calculated using ROC curve to determine the optimal point of diagnosis and assess the diagnostic value. Results The value of ultrasound diagnosis of thyroid nodules is related to the number of positive ultrasound parameters，the risk of malignancy as 12.50%，46.67%，66.67%，81.82%，88.89% and 100% corresponding to the patients with 0，1，2，3，4 and 5 ultrasonographic characteristics. Obscure boundary and aspect ratio has better diagnostic value，the positive predictive value of 90.0% and 90.0% respectively；Nodule size has low diagnostic value，as the positive predictive value of 39.13%；The diagnostic standard of malignant nodules should have at least two positive ultrasound parameters by analysis of the ROC curve，In combination with Bethesda classification of malignant nodules with diagnostic sensitivity 75.00% and specificity of 75.90.Conclusions Ultrasonic In combination with FANC can improve the accuracy of the predicting benign and malignant of thyroid nodules，consequently reducing the diagnostic procedure and excessive treatment. |
| Key words: Ultrasound image, Thyroid nodules, Malignancy,Bethesda system.Fine needle aspiration cytology (FNAC) |
