超声引导下甲状腺结节细针穿刺细胞学检查与超声评估的应用分析

目的探讨超声引导下甲状腺结节细针穿刺细胞学检查与超声评估的应用。方法选取2016年5月～2019年2月我院手术治疗的甲状腺结节患者167例,分别应用超声评估和超声引导下甲状腺结节细针穿刺细胞学检查,以手术病理学结果为对照,评价两种方法诊断结果差异。结果 167例甲状腺结节患者经病理检查恶性结节41例,良性结节患者126例;超声引导下细针穿刺细胞学检查准确度为94.01%,灵敏度为90.24%,均高于超声检查,假阴性率为9.76%,显著低于超声检查,差异均有统计学意义(P0.05)。结论超声引导下细针穿刺细胞学检查同普通超声检查比较具有更高的准确度、灵敏度,为临床诊断和治疗提供重要依据,值得推广应用。     

超声引导下甲状腺结节细针穿刺细胞学检查的重要作用

目的：研究超声引导下甲状腺结节细针穿刺细胞学检查的重要作用。方法：择取在本院就诊的60例甲状腺结节患者，时间段选择：2022年1月至2023年2月。所有患者均进行超声引导下细针穿刺细胞学检查，计算诊断效能。结果：60例甲状腺结节患者中良性与恶性结节分别为48例、12例，超声引导下细针穿刺细胞学检查的检出率依次为78.33%、21.67%，且诊断敏感度为83.33%，特异度为93.75%，准确性为91.67%，阳性与阴性预测值分别为76.92%、95.74%。结论：超声引导下细针穿刺细胞学检查的甲状腺结节诊断准确性高，还可对结节的良恶性进行有效判断，能够给临床医师提供更佳的诊疗方案。     

超声引导下甲状腺结节细针穿刺的临床应用

目的研究超声引导下甲状腺结节细针穿刺的临床应用价值。方法选择2017年4月-2019年1月来我院治疗甲状腺结节的81例患者进行研究,所有患者均经病理证实,于超声引导下行细针穿刺活检,对比病理结果情况。结果对比甲状腺结节患者手术病理结果与活检结果情况,手术病理结果显示81例患者的阴性与阳性分别为71例、10例,而超声引导下细针穿刺活检的阴性与阳性分别为72例、9例,两组数据差异无统计学意义(P>0.05)。结论超声引导下甲状腺结节细针穿刺所呈现出的诊断准确率高,可被临床推广使用。     

超声引导及触诊下细针穿刺活检对甲状腺结节的诊断对比观察

目的分析超声引导下细针穿刺活检能否提高对甲状腺结节诊断的准确性,为临床治疗方法提供可靠依据.方法 100例甲状腺结节的患者中50例行超声引导下细针穿刺活检,另50例甲状腺结节的患者行触诊穿刺活检,并将二者的诊断结果进行比较.结果结节直径大于2 cm的患者超声引导下细针穿刺活检的阳性预告值高于对照组;结节直径小于、等于2 cm的患者超声引导下细针穿刺活检的敏感性和准确性高于对照组.结论超声引导下细针穿刺活检对甲状腺结节诊断的可靠性强,能为临床医生提供可靠依据.     

甲状腺结节超声引导下细针穿刺细胞学与粗针穿刺组织学检查的临床研究

目的:探讨甲状腺结节超声引导下细针穿刺细胞学与粗针穿刺组织学检查的临床应用价值。方法:筛选出2017年1月至2019年10月期间接受治疗的甲状腺结节患者240例,应用数字随机表将患者随机划分为参照组与观察组。参照组应用超声引导下细针穿刺细胞学检测方式,观察组应用超声引导下粗针穿刺组织学检测方式。结果:两组甲状腺良性结节的检测精准度对照,无明显差异(P>0.05),相较于参照组,观察组甲状腺恶性结节的检测精准度明显提高(P<0.05)。结论:超声引导下细针穿刺细胞学与粗针穿刺组织学检测均可有效鉴别甲状腺良性结节,但粗针穿刺组织学检测对甲状腺恶性结节的检测价值更高。     

超声引导下甲状腺结节细针穿刺的诊断价值

目的:评价超声引导下细针穿刺对甲状腺结节的诊断价值。方法:回顾性分析95例甲状腺结节细针穿刺的细胞学检查结果。结果:做出诊断结节93例,其中良性病变67例,17例为恶性病变,9例为细胞非典型病变,2例未做出诊断。结论:超声引导下甲状腺结节细针穿刺准确性高,是诊断甲状腺结节性质的有效方法。     

甲状腺结节TI-RADS分级与超声引导下细针穿刺细胞学检查的联合应用研究

目的:分析并评估将TI-RADS分级结合超声引导下细针穿刺细胞学检查用于甲状腺结节患者临床诊断中的价值。方法:择取2018年1月至2018年11月本医院收入的120例甲状腺结节患者,对患者均采取TI-RADS分级予以甲状腺结节分级,且和超声引导下细针穿刺细胞学检查结果、手术病理诊断结果、随访结果予以比对,分析检查结果。结果:超声引导下细针穿刺细胞学诊断结果和手术病理诊断结果比对,整体符合率是89.29%,诊断甲状腺癌敏感性是85.71%,诊断特异性是92.86%;TI-RADS分级和超声引导下细针穿刺细胞学诊断结果比对,整体符合率是81.67%,诊断甲状腺癌的敏感性是47.06%,诊断特异性是95.35%;TI-RADS分级和手术病理诊断结果比对,整体符合率是89.29%,诊断甲状腺癌敏感性是86.67%,诊断特异性是92.31%;TI-RADS分级结合超声引导下细针穿刺细胞学诊断和手术病理诊断结果的符合率是89.29%。结论:将TI-RADS分级结合超声引导下细针穿刺细胞学检查应用在患者术前甲状腺结节良恶性鉴别中存在重要意义。     

浅析超声引导下细针穿刺活检和超声联合弹性成像诊断甲状腺结节(TN)的临床价值

目的:探讨超声引导下细针穿刺活检和超声联合弹性成像诊断甲状腺结节的临床价值。方法:选取38例于2017年5月至2019年5月来我院影像科进行诊疗的疑为甲状腺结节患者为研究对象,所有患者于术前均行超声引导下细针穿刺活检与超声联合弹性成像检查,以手术病理结果为金标准,比较两种检查方式的诊断准确率。结果:超声联合弹性成像的诊断准确率为93.33%,较超声引导下细针穿刺活检的82.22%明显更高,两种检查方式比较存在显著差异(P<0.05)。结论:针对甲状腺结节的临床诊断,超声引导下细针穿刺活检与超声联合弹性成像各具优势,进行联合检测可提高临床检测的准确率,值得在临床当中推广应用。     

超声造影在甲状腺结节细针穿刺术中的应用价值

目的:探讨超声造影(contrast-enhanced ultrasound,CEUS)在甲状腺结节细针穿刺术(fine needle aspiration,FNA)中的应用价值。方法:选取临床可疑恶性甲状腺结节患者73例(共82个结节),分别行常规超声引导下细针穿刺及超声造影引导下细针穿刺,穿刺针数406针,每个结节均手术并经病理证实。比较这两种方法诊断甲状腺癌的阳性率、穿刺阳性率。结果:73例患者的82个结节中,71个结节病理诊断为甲状腺癌。71个结节一共406针,其中315针(77.6%,315/406)诊断为甲状腺癌。常规超声引导下细针穿刺诊断为甲状腺癌者56个(78.9%,56/71),151针诊断为甲状腺癌,细针穿刺术的灵敏度47.9%,特异度81.3%,准确率55.4%,阳性预测值71.9%,阴性预测值60.9%。超声造影引导下细针穿刺诊断为甲状腺癌者69个(97.2%,69/71),263针诊断为甲状腺癌,细针穿刺术的灵敏度83.5%,特异度80.2%,准确率82.8%,阳性预测值80.8%,阴性预测值82.9%。两种方法之间差异有显著统计学意义。结论:超声造影能提高甲状腺癌诊断的成功率,提高细针穿刺的灵敏度和准确率,引导细针穿刺避开结节内坏死、囊性无血供区域,提高穿刺取材准确率,具有较高的临床应用价值。     

21G和23G细针对超声引导下甲状腺结节穿刺标本满意率的比较

目的比较21G和23G型号细针对甲状腺结节穿刺标本的满意率。 方法2015年1月至2015年2月到首都医科大学附属友谊医院超声医学科进行甲状腺穿刺的病例共123例,123个结节中每个结节分别用21G和23G针进行超声引导下细针穿刺抽吸活组织检查（US-FNAB）,所有标本进行液基细胞学制片,将标本分为满意和不满意2种,21G和23G针穿刺的先后顺序按照随机表进行,比较21G细针和23G细针在进行甲状腺结节穿刺时标本的满意率。 结果21G针穿刺甲状腺结节的标本满意率87.8%（108/123）,23G针穿刺甲状腺结节的标本满意率86.2%（106/123）。差异无统计学意义（χ²=0.045,P>0.05）。 结论23G细针和21G细针在甲状腺结节穿刺中取得标本的满意率相近,23G细针穿刺可以作为一种方法用于临床工作。     

细针穿刺细胞学检查在甲状腺癌碘-131 治疗后复发诊断中的应用价值

目的 评价甲状腺癌术后碘-131治疗的疗效,并探究超声引导下细针穿刺细胞学检查在碘-131治疗后复发病例诊断中的应用价值。方法 选择2011年1月～2018年5月期间甲状腺癌术后在北京大学深圳医院接受放射性碘治疗的474例患者进行随访,采用影像学检查筛选甲状腺癌患者的复发情况,并对这部分患者进行细针穿刺细胞学检测以评价细针穿刺细胞学在甲状腺癌复发患者中的诊断学价值。结果 474例甲状腺癌患者在接受碘-131治疗后,定期超声影像学筛查,筛查出甲状腺癌复发患者56例,超声影像学诊断筛查出甲状腺癌患者复发率为11.81%,对可疑复发的患者行细针穿刺细胞学检查及组织病理学检查,细针穿刺细胞学检查筛查出甲状腺癌复发患者50例,组织病理学检查证实甲状腺癌复发患者50例,经病理学修正后碘-131治疗后甲状腺癌患者复发率为10.55%,超声影像学检查对甲状腺癌患者复发诊断的符合率89.29%,细针穿刺细胞学诊断复发符合率为100%。结论 超声影像学检查是甲状腺癌患者常规使用的复查手段,而对于超声检查发现的可疑淋巴结进行超声引导下细针穿刺细胞学检查的准确率优于单纯的超声影像学检查。     

细针穿刺联合CD147检测对鉴别诊断甲状腺癌的价值

目的研究细针穿刺联合分子标志物CD147检测在甲状腺癌中的应用价值。方法选择2011-2015年收治的48例甲状腺结节患者为研究对象,对患者术后标本进行细针穿刺检测,并对疑似恶性肿瘤的患者进行免疫组化CD147染色分析,若CD147为(+)则判定为恶性,并将其与病理结果相比较。结果 CD147染色结果阴性患者28例,经术后病理检查发现恶性6例,良性22例。良性和恶性结节中,CD147染色结果差异有统计学意义(P0.05)。CD147染色结果与B超提示钙化结节及淋巴结发生转移的关系差异有统计学意义(P0.05)。超声的检测敏感性、阳性预测值及准确率相比单纯细针穿刺和细针穿刺联合分子标志物检测比较,差异有统计学意义(P0.01)。结论分子标志物CD147免疫是诊断甲状腺肿瘤的重要标志物,细针穿刺联合CD147组化分析能明显提高甲状腺癌的术前检出率。     

超声造影结合细针穿刺活检诊断甲状腺结节

目的 探讨超声造影结合细针穿刺活检在诊断甲状腺结节方面的临床价值。 方法 观察我院98例甲状腺结节患者的98个结节,每例患者依次进行二维超声检查及超声造影后,再在超声引导下行细针穿刺活检。以手术病理为标准,评价超声造影及细针穿刺活检对甲状腺结节诊断的准确性。 结果 98例甲状腺结节患者,手术病理诊断良性结节40例,恶性结节58例,超声造影及细针穿刺活检诊断甲状腺结节的敏感性、特异性、准确性分别为72%、68%、70%及78%、73%、76%;超声造影结合细针穿刺活检诊断甲状腺结节的敏感性为91%、特异性为90%、准确性为90%,两种检查方法结合可提高甲状腺结节诊断的敏感性、特异性和准确性,差异有统计学意义（P<0.05）。 结论 超声造影结合细针穿刺活检可在术前更准确、更安全的判断甲状腺结节的良恶性,对甲状腺结节的诊断具有重要的临床意义。       

High-Quality Endoscopic Ultrasound-Guided Fine Needle Aspiration Tissue Acquisition

Endoscopic ultrasound-guided fine needle aspiration is a multistep procedure that involves proper clinical indication, correct selection of needles, adapting evidence-based techniques such as the fanning maneuver and not routinely using suction or the stylet for tissue sampling, and establishing reliable cytopathology support. Integrating cytopathology in the training curriculum and developing a more flexible platform of needles and echoendoscopes are likely to further advance the field of endosonography. This review aims to summarize the technical issues that are key to performing high-quality endoscopic ultrasound-guided fine needle aspiration.     

A Cost-Effective,Rapidly Constructed Simulation Model for Ultrasound-Guided Pericardiocentesis Procedural Training

Background

Emergent ultrasound-guided pericardiocentesis (USGP) is an uncommonly performed procedure by emergency physicians (EPs). USGP simulation models have previously been developed to increase procedural proficiency, but these models are limited for routine implementation secondary to high-cost, lengthy time to construct, and lack of durability. The objective of this study was to develop an USGP simulation model that is cost-effective, easily and rapidly constructed, and has procedure-specific fidelity.

Tuberculous abscess of the thyroid gland: a report of two cases

Tuberculosis of the thyroid gland is very rare, with an acute abscess formation being the least common form of presentation. We report the sono-graphic features of two cases of tuberculous thyroid abscess that were confirmed via ultrasound-guided fine needle aspiration biopsy.     

Prevalence of malignancy in thyroid nodules with an initial nondiagnostic result after ultrasound guided fine needle aspiration

The objective of this study was to determine the rate of malignancy in thyroid nodules with an initial nondiagnostic fine needle aspiration. From October 2001 to April 2007, biopsies were performed on 1344 thyroid nodules in our practice. Biopsies were performed on nodules using 25-27 gauge needles, ultrasound guidance and multiple passes using both suction and capillary action. We retrospectively reviewed the results of these biopsies as well as any further management of nodules that received nondiagnostic results (IRB HUM00006459). Following initial biopsy, 295/1344 (21.9%) of nodules received nondiagnostic pathologic results. Of this population, 39 nodules (13.1%) were lost to follow-up. Of the remaining 256 nodules that received a repeat FNA, surgical excision, or greater than 24 months of clinical and imaging follow-up, only five cancers were detected, representing only 2% of the population that received an initial nondiagnostic biopsy result. All of these cancers were papillary neoplasms. When rigorous, ultrasound-guided, fine needle aspiration of thyroid nodules is performed, a nondiagnostic histopathologic result should not be interpreted as suspicious for thyroid cancer. Given the low rate of malignancy in this population (2%), we suggest that clinical and imaging follow-up of these nodules, opposed to repeat sampling, is warranted.     

Primary thyroid lymphoma: role of ultrasound-guided needle biopsy.

OBJECTIVE: The purpose of this study was to describe the sonographic findings of primary thyroid lymphoma and evaluate the role of ultrasound-guided biopsy in diagnosing thyroid lymphoma. METHODS: This study included 6 patients (age range, 56-72 years; mean, 62.5 years). We searched the database of our institution and retrospectively collected data on the thyroid lymphomas that were confirmed pathologically. All of the sonograms and medical records were reviewed retrospectively. RESULTS: All 6 patients had an enlarged neck mass and underwent ultrasound-guided fine-needle aspiration biopsy. The most notable sonographic feature of primary thyroid lymphoma was a marked hypoechoic mass compared with the residual thyroid tissue. Among the 6 patients with a diagnosis of thyroid lymphoma, 3 (50%) had a diagnosis of lymphoma by ultrasound-guided fine-needle aspiration biopsy. Final pathologic results were obtained by ultrasound-guided core needle biopsy (3/6 patients [50%]) or thyroidectomy (3/6 [50%]). Most patients with thyroid lymphoma (5/6 [83.3%]) were found to have diffuse large B-cell lymphoma and were treated with chemotherapy with or without radiotherapy. In 1 patient with follicular lymphoma, diagnosis and treatment were accomplished by total thyroidectomy. CONCLUSIONS: Our results show that ultrasound-guided core needle biopsy can be a safe and accurate method for diagnosing thyroid lymphoma and may be a suitable replacement for diagnostic thyroid surgery.     

超声引导下甲状腺结节细针穿刺标本满意率影响因素分析

目的探讨超声引导下甲状腺结节细针穿刺标本满意率的影响因素。方法分析960例甲状腺患者1114个结节的细针穿刺活检(FNAB)结果,将标本分为满意和不满意两组,评估甲状腺结节穿刺针类型、超声特征、穿刺针次数及操作者经验对细针穿刺标本满意率的影响。结果22、23G针穿刺标本满意率最高(93.4%)、5ml注射器针头最低(87.3%),差异有统计学意义(P<0.05);结节不同大小、回声及有无钙化的标本满意率比较差异无统计学意义(P>0.05)。穿刺针次数之间标本满意率比较差异无统计学意义(P>0.05)。操作熟练组穿刺标本满意率最高(93.8%)、操作不熟练组最低(89.3%),差异有统计学意义(P<0.05)。结论穿刺针类型及操作者经验是影响甲状腺结节US-FNAB标本满意率的重要因素。