甲状腺结节超声特征对细针抽吸活检无效率的影响分析

目的探讨影响甲状腺结节超声引导下细针抽吸活检(US-FNA)无效率的超声特征。方法选取我院存在恶性风险的甲状腺结节患者235例(共251个结节),根据其常规超声特征(结节大小、位置深度、钙化类型、钙化比例及实性比例)进行分组,均行US-FNA检查并依据Bethesda分类标准判断标本无效率(BethesdaⅠ类为无效,Bethesda≥Ⅱ类为有效),比较各类型分组的无效率,分析相关超声特征对无效率的影响。结果US-FNA无效率比较:①根据结节大小分组,A1组(0.5 cm≤最大径<1.0 cm)无效率最高(42.4%);②根据结节位置深度分组,C2组(深层)无效率最高(41.9%);③根据钙化类型分组,C3组(粗钙化)无效率最高(49.1%);④根据钙化比例分组,D4组(50%<钙化比例≤75%)和E4组(钙化比例>75%)无效率较高,分别为75.0%、80.0%;⑤根据实性比例分组,A5组(0<实性比例≤25%)和B5组(25%<实性比例≤50%)无效率较高,分别为83.3%、80.0%,上述无效率较高组与相应特征类别中的其他组比较,差异均有统计学意义(均P<0.05)。结论甲状腺结节较小(0.5 cm≤最大径<1.0 cm)、位置位于深层、粗钙化、钙化比例>50%、实性比例≤50%等均在一定程度上会造成US-FNA结果不满意。

Influence of ultrasonic features of thyroid nodules on the inefficiency of fine needle aspiration

Objective To investigate the influence of ultrasound characteristics of thyroid nodules on the inefficiency of ultrasound-guided fine-needle aspiration(US-FNA).Methods A total of 235 cases of thyroid nodules(251 nodules)with malignant risk were selected from our hospital.They were grouped according to their conventional ultrasound characteristics(nodule size,depth,type of calcification,proportion of calcification and proportion of solidity).All were examined by US-FNA and the inefficiency of specimens was judged according to the classification standard of Bethesda(Bethesda classⅠwas invalid and Bethesda≥Ⅱwas valid).The inefficiencies of various types of groups were compared,and the impact of relevant ultrasound characteristics on the inefficiency was analyzed.Results US-FNA inefficiency comparison:①grouped by nodules size:group A1(0.5 cm≤Maximum diameter<1 cm)with the highest inefficiency of 42.4%.②grouped by nodules depth,group C2(deep level)with the highest inefficiency of 41.9%.③grouped by calcification type,group C3(coarse calcification)with the highest inefficiency of 49.1%.④grouped by calcification ratio(C-R),the inefficiency of US-FNA were 75.0%and 80.0%in D4 group(50%50%,solid ratio S-R≤50%,will cause the unsatisfactory results of US-FNA to some extent.