Ultrasound-guided fine needle aspiration biopsy for TI-RADS 4 thyroid nodules

doi:10.16139/j.1007-9610.2019.01.016

Abstract

Abstract: Objective To study the value of ultrasound-guided fine needle aspiration biopsy (FNAB) in diagnosing TI-RADS 4 thyroid nodules. Methods A retrospective analysis was conducted on the data of 217 patients with 221 thyroid nodules of TI-RADS 4 by ultrasound-guided FNAB. The cases were divided into TI-RADS 4A group, TI-RADS 4B group and TI-RADS 4C group. Postoperative pathological results were taken as gold standard and Kappa consistency test was used to evaluate the consistency of ultrasound-guided FNAB with postoperative pathological results. The specificity, sensitivity, negative and positive predictive values of ultrasound-guided FNAB were gotten based on postoperative pathological results as standard. Results The Kappa values were 0.86 of TI-RADS 4A group, 0.77 of TI-RADS 4B group and 0.82 of TI-RADS 4C group, respectively. All values were more than 0.75. Specificity, sensitivity, negative and positive predictive values of ultrasound-guided FNAB were 98.1%, 77.8%, 96.2%, 88.0% in TI-RADS 4A group; 90.6%, 86.0%, 88.9%,88.1% in TI-RADS 4B group; and 83.3%, 98.3%, 83.3%, 98.3% in TI-RADS 4C group. Higher consistence was seen between with postoperative pathological results and ultrasound-guided FNAB results (P<0.01). Conclusions Combination of TI-RADS classification and ultrasound-guided FNAB can increase the accuracy of ultrasound diagnosis of TI-RADS 4 thyroid nodules.

Key words: TI-RADS, Ultrasound-guided, Fine needle aspiration biopsy

CLC Number:

R736.1

TAN Xingli, PENG Shiyi, ZHOU Zhiying. Ultrasound-guided fine needle aspiration biopsy for TI-RADS 4 thyroid nodules[J]. Journal of Surgery Concepts & Practice, 2019, 24(01): 75-78.

References

[1] 张春梅, 吴长君, 张雪菊, 等. 超声在甲状腺良恶性结节诊断中的应用[J]. 中国医学影像技术,2007,23(3):385-387.
[2] Kwak JY, Han KH, Yoon JH, et al.Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk[J]. Radiology,2011,260(3):892-899.
[3] 李芹芹, 叶廷军, 毛静静. 超声TI-RADS分类对甲状腺结节的诊断价值[J]. 诊断学理论与实践,2017,16(6):607-611.
[4] 何俊峰, 闫国珍, 刘扬, 等. 甲状腺微小癌超声引导下细针穿刺细胞学与粗针穿刺组织学检查的临床对比研究[J]. 中国超声医学杂志,2018,34(3):211-213.
[5] 周伟, 周丹, 詹维伟, 等. 超声引导下甲状腺结节细针穿刺抽吸活检术出血原因分析[J]. 外科理论与实践,2016,21(2):146-149.
[6] Liu X, Medici M, Kwong N, et al.Bethesda categorization of thyroid nodule cytology and prediction of thyroid cancer type and prognosis[J]. Thyroid,2015,26(2):256-261.
[7] Lee YS, Kim HK, Chang H, et al.Diagnostic thyroidectomy may be preferable in patients with suspicious ultrasonography features after cytopathology diagnosis of AUS/FLUS in the Bethesda System[J]. Medicine(Baltimore),2015,94(51):e2183.
[8] Nachiappan AC, Metwalli ZA, Hailey BS, et al.The thyroid: review of imaging features and biopsy techniques with radiologic pathologic correlation[J]. Radiographics, 2014,34(2):276-293.
[9] 吴亮, 杨顺实, 江学庆, 等. 超声引导下甲状腺结节细针穿刺细胞学检查的术前诊断价值[J]. 中国临床医学影像杂志,2014,2(1)5:17-20.
[10] 郑斌, 詹维伟, 倪晓枫, 等. 超声引导下细针穿刺抽吸活检对TI-RADS 4类甲状腺结节的诊断价值[J]. 上海交通大学学报(医学版),2014,34(8):1206-1209.
[11] Gharib H, Papini E, Paschke R, et al.American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations[J]. J Endocrinol Invest,2010,33(5 Suppl):51-56.
[12] 郑斌, 李成, 王燕, 等. 声触诊组织量化联合细针抽吸活检对TI-RADS 4类甲状腺结节的诊断价值[J]. 外科理论与实践,2016,21(4):306-311.
[13] 吴亮, 杨顺实, 余芬, 等. 操作经验对超声引导下甲状腺结节细针穿刺活检的影响[J]. 中华内分泌外科杂志,2012,6(6):404-408.
[14] 高秋霞, 张明礼, 程艳, 等. 超声引导下甲状腺结节细针穿刺细胞学检查的应用现状[J]. 肿瘤学杂志,2016, 22(10):856-860.
[15] Haberal AN, Toru S, Ozen O, et al.Diagnostic pitfalls in the evaluation of fine needle aspiration cytology of the thyroid: correlation with histopathology in 260 cases[J]. Cytopathology,2009,20(2):103-108.
[16] 刘芳, 何欣, 张丽, 等. 甲状腺细针穿刺细胞学漏诊与误诊15例[J]. 临床与实验病理学杂志,2017,33(8):922-924.