目的:分析超声引导下细针穿刺活检联合甲状腺影像报告和数据系统(thyroid imaging reporting and data system,TI-RADS)诊断甲状腺良、恶性结节的效能。方法:选取2022年1月—2024年9月南通市第二人民医院收治的90例患者(102枚结节),所...目的:分析超声引导下细针穿刺活检联合甲状腺影像报告和数据系统(thyroid imaging reporting and data system,TI-RADS)诊断甲状腺良、恶性结节的效能。方法:选取2022年1月—2024年9月南通市第二人民医院收治的90例患者(102枚结节),所有结节都进行了超声TI-RADS分级及超声引导下细针穿刺活检,以术后大体病理结果为金标准,研究两种检查方法及联合检查诊断甲状腺结节良、恶性的效能。结果:TI-RADS诊断甲状腺恶性肿瘤的阳性预测值、阴性预测值和准确性分别为80.56%、93.33%、84.31%;超声引导下细针穿刺活检诊断甲状腺恶性肿瘤的阳性预测值、阴性预测值和准确性分别为80.00%、100%、88.24%;两者联合诊断甲状腺恶性肿瘤的阳性预测值、阴性预测值和准确性分别为80.82%、96.55%、85.29%。TI-RADS、超声引导下细针穿刺活检和两者联合诊断甲状腺恶性肿瘤的AUC分别为0.82[95%CI(0.74,0.89)]、0.90[95%CI(0.85,0.95)]和0.96[95%CI(0.93,0.98)],TI-RADS与超声引导下细针穿刺活检的AUC差异无统计学意义(z=1.83,P=0.068),两者联合的AUC要高于TI-RADS(z=4.44,P<0.001)和超声引导下细针穿刺活检(z=3.12,P=0.002)。结论:超声引导下细针穿刺活检联合TI-RADS较单一方法诊断甲状腺结节良、恶性具有更高的效能,有较高的临床应用价值。展开更多
目的:探讨经支气管针吸活检术联合建隧活检在临床中的应用价值。方法:回顾性分析济宁医学院附属医院呼吸与危重症学科在2023年1月至2024年10月期间胸部CT/胸部增强CT示有肺门/纵隔淋巴结肿大和(或)肺周围病变的病例患者的临床资料分3组...目的:探讨经支气管针吸活检术联合建隧活检在临床中的应用价值。方法:回顾性分析济宁医学院附属医院呼吸与危重症学科在2023年1月至2024年10月期间胸部CT/胸部增强CT示有肺门/纵隔淋巴结肿大和(或)肺周围病变的病例患者的临床资料分3组,53例行C-TBNA检查的患者为1组、31例行C-TBNA联合建隧活检检查的患者为2组、324例行EBUS-TBNA检查的患者为3组,收集上述3组患者的病理学检查结果、穿刺部位,计算敏感度、特异度、准确率。结果:行C-TBNA诊断的敏感度为79%,特异度为100%,诊断准确率为80.8%;行C-TBNA联合建隧活检诊断的敏感度为95.4%,特异度100%,准确率96.7%;行EBUS-TBNA诊断的敏感度为93.5%,特异度100%,准确率95%;3组准确率相比差异有统计学意义(χ2 = 11.532, P = 0.002, P 0.05)。结论:C-TBNA联合建隧活检诊断率高于C-TBNA,且不劣于EBUS-TBNA相比,该项技术可以用于纵隔和肺门淋巴结的诊断评估。Objective: To investigate the clinical value of transbronchial needle aspiration biopsy combined with tunnel biopsy. Methods: A retrospective analysis was performed for the clinical data of patients with hilar/mediastinal lymphadenopathy and/or peripulmonary lesions on chest CT/chest contrast- enhanced CT from January 2023 to October 2024, including 1 group of 53 patients who underwent C-TBNA, 2 groups of 31 patients who underwent C-TBNA combined with tunnel biopsy, and 3 groups of 324 patients who underwent EBUS-TBNA. The pathological examination results and puncture sites of the above three groups were collected, and the sensitivity, specificity and accuracy were calculated. Results: The sensitivity, specificity and accuracy of C-TBNA were 79%, 100%, and 80.8%. The sensitivity and specificity of C-TBNA combined with tunnel biopsy were 95.4%, the specificity was 100%, and the accuracy was 96.7%. The sensitivity and specificity of EBUS-TBNA were 93.5%, the specificity was 100%, and the accuracy was 95%. There was a statistically significant difference in accuracy between the three groups (χ2 = 11.532, P = 0.002, P 0.05). Conclusions: Compared with EBUS-TBNA, this technique can be used for the diagnostic evaluation of mediastinal and hilar lymph nodes.展开更多
文摘目的:分析超声引导下细针穿刺活检联合甲状腺影像报告和数据系统(thyroid imaging reporting and data system,TI-RADS)诊断甲状腺良、恶性结节的效能。方法:选取2022年1月—2024年9月南通市第二人民医院收治的90例患者(102枚结节),所有结节都进行了超声TI-RADS分级及超声引导下细针穿刺活检,以术后大体病理结果为金标准,研究两种检查方法及联合检查诊断甲状腺结节良、恶性的效能。结果:TI-RADS诊断甲状腺恶性肿瘤的阳性预测值、阴性预测值和准确性分别为80.56%、93.33%、84.31%;超声引导下细针穿刺活检诊断甲状腺恶性肿瘤的阳性预测值、阴性预测值和准确性分别为80.00%、100%、88.24%;两者联合诊断甲状腺恶性肿瘤的阳性预测值、阴性预测值和准确性分别为80.82%、96.55%、85.29%。TI-RADS、超声引导下细针穿刺活检和两者联合诊断甲状腺恶性肿瘤的AUC分别为0.82[95%CI(0.74,0.89)]、0.90[95%CI(0.85,0.95)]和0.96[95%CI(0.93,0.98)],TI-RADS与超声引导下细针穿刺活检的AUC差异无统计学意义(z=1.83,P=0.068),两者联合的AUC要高于TI-RADS(z=4.44,P<0.001)和超声引导下细针穿刺活检(z=3.12,P=0.002)。结论:超声引导下细针穿刺活检联合TI-RADS较单一方法诊断甲状腺结节良、恶性具有更高的效能,有较高的临床应用价值。
文摘目的:探讨经支气管针吸活检术联合建隧活检在临床中的应用价值。方法:回顾性分析济宁医学院附属医院呼吸与危重症学科在2023年1月至2024年10月期间胸部CT/胸部增强CT示有肺门/纵隔淋巴结肿大和(或)肺周围病变的病例患者的临床资料分3组,53例行C-TBNA检查的患者为1组、31例行C-TBNA联合建隧活检检查的患者为2组、324例行EBUS-TBNA检查的患者为3组,收集上述3组患者的病理学检查结果、穿刺部位,计算敏感度、特异度、准确率。结果:行C-TBNA诊断的敏感度为79%,特异度为100%,诊断准确率为80.8%;行C-TBNA联合建隧活检诊断的敏感度为95.4%,特异度100%,准确率96.7%;行EBUS-TBNA诊断的敏感度为93.5%,特异度100%,准确率95%;3组准确率相比差异有统计学意义(χ2 = 11.532, P = 0.002, P 0.05)。结论:C-TBNA联合建隧活检诊断率高于C-TBNA,且不劣于EBUS-TBNA相比,该项技术可以用于纵隔和肺门淋巴结的诊断评估。Objective: To investigate the clinical value of transbronchial needle aspiration biopsy combined with tunnel biopsy. Methods: A retrospective analysis was performed for the clinical data of patients with hilar/mediastinal lymphadenopathy and/or peripulmonary lesions on chest CT/chest contrast- enhanced CT from January 2023 to October 2024, including 1 group of 53 patients who underwent C-TBNA, 2 groups of 31 patients who underwent C-TBNA combined with tunnel biopsy, and 3 groups of 324 patients who underwent EBUS-TBNA. The pathological examination results and puncture sites of the above three groups were collected, and the sensitivity, specificity and accuracy were calculated. Results: The sensitivity, specificity and accuracy of C-TBNA were 79%, 100%, and 80.8%. The sensitivity and specificity of C-TBNA combined with tunnel biopsy were 95.4%, the specificity was 100%, and the accuracy was 96.7%. The sensitivity and specificity of EBUS-TBNA were 93.5%, the specificity was 100%, and the accuracy was 95%. There was a statistically significant difference in accuracy between the three groups (χ2 = 11.532, P = 0.002, P 0.05). Conclusions: Compared with EBUS-TBNA, this technique can be used for the diagnostic evaluation of mediastinal and hilar lymph nodes.
