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目的探讨B超检查9、9m过锝酸盐(99mTcO4-)显像和细针穿刺活检(FNAC)诊断甲状腺结节的临床价值。方法对168例甲状腺结节患者术前行FNAC、B超9、9mTcO4-显像检查,术后行常规细胞病理学检查,比较三种方法对甲状腺结节诊断的临床价值。结果 168例中,甲状腺结节术后细胞病理学检查诊断为甲状腺癌25例(14.9%),良性结节143例(85.1%)。与之比较:B超检查灵敏度24.0%,特异度99.3%,阳性预测值85.7%,阴性预测值88.2%;99mTcO4-显像灵敏度40.0%,特异度97.9%,阳性预测值76.9%,阴性预测值90.3%;FNAC检查灵敏度68.0%,特异度94.6%,阳性预测值94.4%,阴性预测值94.6%。结论 B超9、9mTcO4-显像和FNAC三种检查方法在临床诊断甲状腺结节中各有优缺点。
Objective To investigate the clinical value of ultrasonography in the diagnosis of thyroid nodules with 99mTcO4- imaging and fine needle aspiration biopsy (FNAC). Methods 168 patients with thyroid nodules were examined with FNAC and B ultrasound 9,9mTcO4-imaging before operation. The routine cytopathological examination was performed to compare the clinical value of the three methods in the diagnosis of thyroid nodules. Results Among the 168 cases, 25 cases (14.9%) were diagnosed as thyroid cancer by cytopathology and 143 cases (85.1%) were benign nodules. The sensitivity and specificity of B ultrasound were 24.0%, 99.3%, 85.7% and 88.2%, respectively. The sensitivity of 99mTcO4-imaging was 40.0%, the specificity was 97.9%, the positive predictive value was 76.9%, the negative predictive value 90.3%; FNAC examination sensitivity 68.0%, specificity 94.6%, positive predictive value 94.4%, negative predictive value 94.6%. Conclusion B ultrasound 9,9 mTcO4-imaging and FNAC three methods in the clinical diagnosis of thyroid nodules have their own advantages and disadvantages.