彩超引导粗针穿刺活检对比细针吸取诊断甲状腺结节的应用价值

目的：评价彩色多普勒引导下粗针穿刺活检（CNB）和细针吸取（FNA）甲状腺结节良、恶性的准确性和安全性。方法：回顾性分析141例甲状腺结节均行CNB和FNA,并对比CNB和FNA在诊断甲状腺结节良、恶性的诊断符合率和术后并发症发生率之间的比较。结果：141例甲状腺结节中CNB和FNA诊断符合率分别为99.29%和93.61%,差异有统计学意义（P〈0.05）;本组研究中CNB良性结节符合率为100%,FNA诊断良性结节的符合率95.38%;恶性结节CNB诊断符合率90.9%（10/11）,FNA诊断符合率72.72%（8/11）。CNB和FNA特异性分别99.29%和93.61%;CNB和FNA敏感性分别为100%、95.38%;CNB和FNA出现皮下血肿分别是1.41%、0.07%,差异无统计学意义（P〉0.05）。结论：甲状腺结节在彩超引导下CNB比FNA更准确,同样是一种安全、简便鉴别甲状腺结节良、恶性的方法并可以更准确地指导临床治疗,能减少良性结节手术率。

Study of Color-Doppler guided core needle biopsy versus fine-needle aspiration for the diagnosis of thyroid nodules

Objective： To evaluate the accuracy and security of color-doppler guides core-needle biopsy （CNB） and fine-needle aspiration（FNA） for the diagnosis of thyroid nodules. Methods： We evaluated the results of CNB and FNA in 141 case thyroid nodules with comparing final diagnoses. We assessed the accuracy and security of CNB and FNA for the diagnosis of thyroid nodules. Results： For the 141 cases of thyroid nodule, CNB and FNA showed diagnostic coincidence rate of 99.29% and 93.61%, and the difference was statistically significant （P〈0.05）. For benign nodules diagnosed by CNB, the coincidence rate was 100%, while for FNA diagnosis the coincidence rate of the benign nodules was 95.38%. For malignant nodules diagnosed by CNB diagnosis, the coincidence rate was 90.9%, for FNA diagnosis the coincidence rate was 72.72%. The specificity of CNB and FNA was 100% ,95.38%. Incidence of subcutaneous hematoma for CNB and FNA was 1.41% and 0.07% respectively showing no significant difference. Conclusion： Color-Doppler guided CNB is more safe and more accurate in diagnosis of thyroid nodule, especial- ly for differentiation diagnosis of benign and malignant diseases.