Study on ultrasound-guided puncture biopsy combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant thyroid nodules
超声引导下穿刺活检联合超声造影在甲状腺结节良恶性诊断中研究

摘要

目的 探究在鉴别甲状腺结节良恶性方面，超声引导下穿刺活检与超声造影技术相结合的应用效果。方法 选择2021年1月-2024年1月期间在我院行甲状腺结节切除术的患者70例。所有患者在术前均接受超声引导下穿刺活检和超声造影检查及联合检查，并以术中快速病理切片诊断结果为金标准。对超声引导下穿刺活检和超声造影检查及联合检查的灵敏度、特异度、准确率进行对比与评估。同时，分析良恶性结节的超声表现。结果 70例患者，共发现74枚甲状腺结节，其中23例恶性（25枚结节）、47例良性（49枚结节）。超声引导穿刺活检检出52良、22恶；超声造影检出46良、28恶。联合应用确诊50良、24恶，灵敏度96%、特异性100%、准确率98.65%，这些指标均优于单独使用超声引导穿刺活检（92%、97.96%、97.30%）或超声造影（84%、85.74%、85.14%）有统计学意义（P＜0.05），与穿刺活检单独使用时相比，差异无统计学意义（P＞0.05）。结论 在对甲状腺结节良恶性诊断中实施超声引导下穿刺活检联合超声造影检测取得明显的效果，可显著提高诊断效能。有较高应用价值。

Abstract

Objective: Analysis of ultrasound-guided puncture biopsy combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant thyroid nodules.
Methods: 70 patients who underwent thyroid nodulectomy in our hospital between January 2023 and January 2024 were selected. All patients underwent ultrasound-guided puncture biopsy, contrast-enhanced ultrasound examination, and combined examination before surgery, with the intraoperative rapid pathological section diagnosis result as the gold standard. Compare and evaluate the sensitivity, specificity, and accuracy of ultrasound-guided puncture biopsy, contrast-enhanced ultrasound examination, and combined examination. Meanwhile, analyze the ultrasound manifestations of benign and malignant nodules.
Results: Out of 70 patients, a total of 74 thyroid nodules were found, including 23 malignant (25 nodules) and 47 benign (49 nodules). Ultrasound guided biopsy detected 52 positive and 22 negative cases; Ultrasound contrast imaging detected 46 positive and 28 negative cases. The combined application diagnosed 50 good and 24 evil cases, with a sensitivity of 96%, specificity of 100%, and accuracy of 98.65%. These indicators were superior to using ultrasound-guided biopsy alone (92%, 97.96%, 97.30%) or contrast-enhanced ultrasound alone (84%, 85.74%, 85.14%) with statistical significance (P<0.05), but there was no significant difference compared to using biopsy alone (P>0.05).
Conclusion  : The implementation of ultrasound-guided puncture biopsy combined with contrast-enhanced ultrasound detection in the diagnosis of benign and malignant thyroid nodules has achieved significant results, which can significantly improve diagnostic efficiency. Has high application value.