目的 探讨高频彩色多普勒超声(HF-CDU)联合超声辅助下细针穿刺细胞学检查(US-FNAC)在甲状腺癌鉴别诊断中的应用价值.方法 将2020年2月至2023年3月在安徽医科大学直属附属六安医院(六安市人民医院)收治的110例甲状腺结节患者纳入本次回顾性研究.患者均接受HF-CFU检查和US-FNAC检查,以术后病理检查结果为"金标准",分析不同性质结节的高频彩色多普勒超声的影像学特征,比较HF-CDU检查和US-FNAC单独检测和二者联合检测在甲状腺癌诊断中的灵敏性、特异性、准确性、假阳性和假阴性.结果 110例患者共计有133个甲状腺结节,术后病理检查结果显示,恶性结节占比58.65%(78/133),良性结节占比41.35%(55/133);单发结节占比80.00%(88/110),多发结节占比20.00%(22/110).超声检查显示,恶性结节的主要特征是血流分布多、纵横比≥1、微小钙化、形态不规则、边界毛糙或模糊、内部低或极低回声.HF-CDU检查的灵敏性、特异性、准确度、假阳性率和假阴性率分别为 85.90%、89.09%、87.22%、10.91%和 14.10%;US-FNAC 检查的分别为 89.74%、92.73%、90.98%、7.27%、10.26%;联合检测的分别为96.15%、94.55%、95.49%、5.45%、3.85%,联合检测的灵敏性、特异性、准确性、假阳性和假阴性率均优于HF-CDU、US-FNAC单独检测.结论 HF-CDU、US-FNAC联合检测可有效提高甲状腺癌的确诊率,能够为患者早诊断、早治疗、提高预后提供可靠的方法.
Objective To explore the application value of high-frequency color Doppler ultrasound(HF-CDU)combined with ultra-sound assisted fine needle aspiration cytology(US-FNAC)in the differential diagnosis of thyroid cancer.Methods A retrospective study was conducted on 110 patients with thyroid nodules admitted to Lu'an Hospital Affiliated to Anhui Medical University(Lu'an People's Hospital)from February 2020 to March 2023.Patients underwent both HF-CDU and US-FNAC examinations,using postoperative pathological examination re-sults as the"gold standard".The imaging characteristics of HF-CDU of different types of nodules were analyzed.The sensitivity,specificity,ac-curacy,false positive and false negative of HF-CDU,US-FNAC,and their combination detection in the diagnosis of thyroid cancer were com-pared.Results A total of 133 thyroid nodules were found in 110 patients.Postoperative pathological examination showed that malignant nodules accounted for 58.65%(78/133)and benign nodules accounted for 41.35%(55/133).Single nodules accounted for 80.00%(88/110),and multiple nodules accounted for 20.00%(22/110).Ultrasound examination showed that the main characteristics of malignant nodules were abun-dant blood flow distribution,aspect ratio ≥ 1,small calcification,irregular morphology,rough or blurry boundaries,and low or extremely low inter-nal echoes.The sensitivity,specificity,accuracy,false positive rate,and false negative rate of HF-CDU were 85.90%,89.09%,87.22%,10.91%,and 14.10%,respectively,the corresponding data of US-FNAC examination were 89.74%,92.73%,90.98%,7.27%,and 10.26%,respectively,the corresponding data of combined detection were 96.15%,94.55%,95.49%,5.45%,and 3.85%,respectively.The sensitivity,specificity,accuracy,false positive and false negative rates of the combined detection were better than those of HF-CDU and US-FNAC alone.Conclusion The combined detection of HF-CDU and US-FNAC can effectively improve the diagnostic rate of thyroid cancer,providing a reliable method for patients to diagnose,treat,and improve prognosis early.