超声造影联合细针穿刺细胞学检查对C-TIRADS 4类甲状腺结节的诊断价值分析

doi:10.3969/j.issn.1671-7171.2025.03.011

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Abstract 【Objective】To evaluate the value of contrast-enhanced ultrasound(CEUS) combined with fine needle aspiration cytology in the diagnosis of Category 4 of thyroid nodules in Chinese Thyroid Image Report and Data System (C-TIRADS). 【Methods】The clinical data of 106 patients with C-TIRADS 4 thyroid nodules admitted to our hospital from April 2021 to April 2023 were retrospectively analyzed, with a total of 132 thyroid nodules. With postoperative histopathological examination as the gold standard, the preoperative CEUS and ultrasound-guided fine needle puncture cytology data were complete, and the sensitivity, specificity and accuracy of CEUS and ultrasound-guided fine needle puncture cytology in the diagnosis of benign and malignant C-TIRADS 4 of thyroid nodules were analyzed. 【Results】Among 132 thyroid nodules of C-TIRADS 4, the results of histopathological examination were as follows: 96 malignant nodules (72.73%) were thyroid papillary carcinoma. There were 36 benign thyroid nodules (27.27%), 28 nodular goiter and 8 nodular cysts. The positive predictive value and negative predictive value of CEUS in the diagnosis of C-TIRADS 4 malignant thyroid nodules were 91.76% and 61.70%, respectively. The diagnostic accuracy was 81.06%, and the consistency Kappa value was 0.564. The positive predictive value and negative predictive value of ultrasound guided fine needle puncture cytology in the diagnosis of C-TIRADS 4 thyroid malignant nodules were 100.00% and 75.00%, respectively, the diagnostic accuracy was 90.91%, and the consistency Kappa value was 0.792. The positive predictive value and negative predictive value of CEUS combined with fine needle puncture in the diagnosis of C-TIRADS 4 thyroid malignant nodules were 93.07%, 93.55%, 93.18%, and the consistency Kappa value was 0.820. Receiver operating characteristics (ROC) curve analysis showed that the sensitivity of CEUS combined with ultrasound -guided fine needle aspiration cytology in the diagnosis of C-TIRADS 4 thyroid nodules was higher than that of single diagnosis (P<0.05), and there was no significant difference in specificity and area under the curve (P>0.05). 【Conclusion】 Contrast-enhanced ultrasound combined with fine needle aspiration cytology has high accuracy in the diagnosis of C-TIRADS 4 thyroid nodules, and can be used to assist in the diagnosis of C-TIRADS 4 thyroid nodules.

Key words： Thyroid Nodule Ultrasonography Biopsy, Fine-Needle

Received: 27 August 2024

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R736.1

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2025.03.011 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2025/V42/I3/405

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