本文選題：甲狀腺結(jié)節(jié)　切入點(diǎn)：細(xì)針穿刺　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:評(píng)價(jià)細(xì)針穿刺細(xì)胞學(xué)檢查(FNA)、CT、MRI及超聲造影(CEUS)在甲狀腺癌診斷中的應(yīng)用價(jià)值,指導(dǎo)臨床更好、更合理地運(yùn)用這些檢查進(jìn)行結(jié)節(jié)良惡性的鑒別。方法:回顧性分析廣西醫(yī)科大學(xué)第一附屬醫(yī)院2015年8月-2016年11月份經(jīng)手術(shù)病理證實(shí)的226例甲狀腺結(jié)節(jié)患者共282個(gè)結(jié)節(jié)(其中,良性結(jié)節(jié)193個(gè),惡性結(jié)節(jié)89個(gè)),術(shù)前行FNA、CT、MRI、CEUS中的一項(xiàng)或多項(xiàng)檢查的影像學(xué)及組織病理學(xué)資料,各組間年齡比較進(jìn)行方差分析,各組間性別的比較采用行×列表卡方檢驗(yàn),分別計(jì)算FNA、CT、MRI、CEUS以及兩兩聯(lián)合診斷甲狀腺癌的準(zhǔn)確率等各項(xiàng)診斷效能,并進(jìn)一步計(jì)算根據(jù)結(jié)節(jié)直徑分組(A組:直徑≤1cm,B組:直徑1cm)后的FNA、CEUS及CT的上述指標(biāo),再比較各項(xiàng)檢查及兩兩聯(lián)合后的準(zhǔn)確率是否有差異。準(zhǔn)確率的比較采用Fisher精確檢驗(yàn)。結(jié)果:各檢查組間年齡、性別比較無(wú)統(tǒng)計(jì)學(xué)差異。FNA在診斷甲狀腺癌中的準(zhǔn)確率為87.93%;CT為67.50%;CEUS為78.26%;MRI為60.00%。兩兩準(zhǔn)確率的比較:FNA與CT比較,FNA與MRI以及CEUS與CT比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);FNA與CEUS比較,CEUS與MRI比較,以及CT與MRI比較差異無(wú)顯著性(P0.05)。所有兩兩聯(lián)合檢查的準(zhǔn)確率比較差異無(wú)顯著性(P0.05)。A組(≤1cm組)中,FNA的準(zhǔn)確率為92.86%;CT為61.22%;CEUS為65.85%。A組組內(nèi)兩兩準(zhǔn)確率比較:FNA與CT比較,FNA與CEUS比較,差異具有顯著性(P0.05);CEUS與CT比較,差異無(wú)顯著性(P0.05)。B組(1cm組)中,FNA準(zhǔn)確率為86.36%;CT為70.75%;CEUS為88.68%。B組組內(nèi)兩兩準(zhǔn)確率比較:FNA與CT比較,CEUS與CT比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);FNA與CEUS比較,差異無(wú)顯著性(P0.05)。結(jié)論:在甲狀腺良惡性鑒別診斷上,不論結(jié)節(jié)大小FNA的診斷效能均優(yōu)于CT和MRI;結(jié)節(jié)≤1cm時(shí),FNA的診斷效能優(yōu)于CEUS;結(jié)節(jié)1cm時(shí),CEUS的診斷效能優(yōu)于CT。而CT與MRI的準(zhǔn)確率差異并無(wú)顯著性。
[Abstract]:Objective: to evaluate the value of fine needle aspiration cytology in the diagnosis of thyroid carcinoma. Methods: a retrospective analysis was made of 282 thyroid nodule cases in the first affiliated Hospital of Guangxi Medical University from August 2015 to November 2016, which were proved by operation and pathology. There were 193 benign nodules and 89 malignant nodules. The imaging and histopathological data of one or more items of FNAOCTMRICEUS were performed before operation. The age of each group was analyzed by ANOVA, and the sex of each group was compared by X list chi-square test. The diagnostic efficacy of MRICEUS and the accuracy rate of the combined diagnosis of thyroid carcinoma were calculated, and the above indexes of FNACEUS and CT were further calculated in group A (diameter 鈮，

本文編號(hào)：1606338