文章摘要

超声引导下细针穿刺甲状腺结节Bethesda I类标本的影响因素

作者: 1阳仔怡, 1危安
1 湖南师范大学附属第一医院(湖南省人民医院)超声二科,长沙 410000
通讯: 危安 Email: weian1976@163.com
DOI: 10.3978/j.issn.2095-6959.2021.06.037

摘要

近年来,甲状腺结节检出率显著升高,不同病理类型的甲状腺癌存活率不同,但大多数甲状腺癌预后较好。这使得对恶性结节尽早做出明确诊断至关重要,超声引导下细针穿刺细胞学检查(ultrasound-guided fine needle aspiration biopsy,US-FNAB)是甲状腺结节术前定性诊断的主要方法,但其最主要的缺点在于标本无法诊断或不满意(Bethesda I类),其影响因素为操作者熟练程度、结节特征、穿刺工具、穿刺方法、标本现场评估、其他,其解决方法为重复穿刺、立体定向三点一线择优穿刺法、检测肿瘤标志物、成立活检中心、现场视觉评估、粗针穿刺活检、薄层液基细胞涂片法。
关键词: 细针穿刺;超声引导;甲状腺;结节

Influencing factors of Bethesda I of thyroid nodules under ultrasound-guided fine needle aspiration

Authors: 1YANG Ziyi, 1WEI An
1 Second Department of Ultrasound, First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), Changsha 410000, China

CorrespondingAuthor: WEI An Email: weian1976@163.com

DOI: 10.3978/j.issn.2095-6959.2021.06.037

Abstract

In recent years, the detection rate of thyroid nodules has increased significantly. Different types of thyroid cancer have different survival rates, but most thyroid cancers have a good prognosis. This makes it important to make a definitive diagnosis of malignant nodule as soon as possible. Ultrasound guided fine needle aspiration biopsy (US-FNAB) is the main method for qualitative diagnosis of thyroid nodules before operation. However, its major disadvantage is that the specimen cannot be diagnosed or is unsatisfactory (Bethesda I type). The influencing factors are operator proficiency, nodule characteristics, puncture tools, puncture methods, immediate assessment of specimens, etc. and solutions are repeated puncture, stereotactic three-point and one-line selective puncture method, detection of tumor markers, setting up a biopsy center, on-site visual assessment, thick needle aspiration biopsy, thin layer liquid-based cell smear method.
Keywords: fine needle aspiration; ultrasound-guided; thyroid; nodule