Retrospective Study Of 45 Cases Of Thyroid Fine Needle Aspiration Biopsy Under Ultrasound Guidance

Objective: With medical staff medical technology and the constant improvement of the diagnosis and treatment level and the change of natural environment and diet habits change of subjective and objective reasons,such as thyroid nodule was found in a growing number of people and diagnosis.Therefore,it is very important for doctors and patients to attach importance to the diagnosis and treatment of nodules.Although most of the lesions are benign,the likelihood of malignancy is around 4-6%.But because the thyroid nodule onset of clinical symptoms are not like other physicians and most diseases has its remarkable characteristic,therefore difficult to early detection and identification,especially for small lesions.Medical staff how to accurately to early diagnosis of nodular,to formulate the reasonable diagnosis and treatment plan,and then try to avoid the occurrence of misdiagnosis and missed diagnosis and cause excessive examination and treatment to patients,is what is needed to face the problem.(thyroid fine needle biopsy under ultrasound guided fine needle aspiration biopsy,FNA)as physicians and clinical doctor for early diagnosis of thyroid nodule a common inspection method,though still has its limitations,but to differentiate benign and malignant nodules,to standardize nodule diagnosis and treatment of patients,reduce the patients to disease is effective of worry and fear,to quality survival in patients with greatly improved.This article explores FNA(22 G)and ultrasound for the thyroid nodules benign and malignancy,particularly for malignant lesions,thyroid cancer,thyroid cancer,TC)diagnostic significance.Methods : Retrospective analysis from January 2017 to December 2017,45 cases of patients with thyroid nodules,all guided by ultrasound in patients with thyroid fineneedle biopsy(22 g)and thyroid surgery,and collect the patient's postoperative pathological diagnosis.Compare biopsy in conformance with the postoperative pathological diagnosis,summarize the ultrasonic image characteristics of benign and malignant nodules,to explore the clinical commonly used color doppler ultrasound and thyroid FNA value to the diagnosis of thyroid nodules.Results:(1)Compare the thyroid nodules in patients with postoperative pathological data,the accuracy of fine-needle aspiration cytology test results was95.56%,specificity and sensitivity for thyroid cancer diagnosis were 84.62%,96.88%,the missed diagnosis and misdiagnosis rate was 3.12%,15.38%.(2)Diction in fine needle biopsy of 45 cases of 32 cases of thyroid nodules in patients with malignant,benign,13 cases after postoperative histopathological examination confirmed the results of the thyroid is 33 patients with thyroid cancer,12 patients with benign lesions.(3)In FNA examination in the diagnosis of 32 cases of thyroid cancer patients,including 28 cases of malignant degree is low but easily occurred early patients with cervical lymph node metastasis of papillary carcinoma,3 cases of follicular malignant tumor patients,only 1 case of malignant degree relatively high medullary carcinoma.In contrast,in the diagnosis of the patients with benign lesions,the largest number of nodular goiter(7 cases),diagnosis of adenoma,the number of times(3 cases),as one of clinical common autoimmune thyroid disease in 2 cases of hashimoto's thyroiditis,at least for subacute thyroiditis,only 1 case.(4)Combined with postoperative histopathological biopsy results,patients with postoperative histopathological examination confirmed the nodules can be divided into benign and malignant two groups,and focused on the incidence of both,according to the age group of < 45 years old,or 45 years of age and gender,single or multiple nodules were compared respectively,and suggests that there is an obvious difference between(P < 0.05),and in the nodules occur among women more than men,multiple nodular lesions often benign,single nodule lesions are often vicious hints.(5)From ultrasonic acoustic image on the difference between the nature of the nodules,echo intensity is relatively high,the boundary is relatively clear,around the nodules or internal blood flow,or blood flow signals in bulky calcified nodules surrounding or exist,these often are benign lesions.The malignant nodules are the opposite.(6)Malignant thyroid lesions in this study to a relatively good prognosis in patients with thyroid papillary carcinoma is relatively rare,and cytology on display for nuclear groove and the emergence ofintranuclear inclusions in the is the typical pathological characteristics of papillary thyroid cancer.(7)In patients with postoperative pathological diagnosis of TC,there were 30 patients with a diameter of less than 2cm,3 patients with 2-4cm,and 0 cases of > 4cm.In 2 patients were found to exist in the all of the patients in a nearby transfer,is often a transfer on the neck lymph nodes around the organization,in the case data of this study did not see the distant organ metastasis patients.Conclusions:(1)Thyroid ultrasonography plays an important role in the diagnosis of nodules due to its safety,noninvasiveness,high accuracy and easy clinical operation.It can from the position of the nodules,nodule size,shape description,the nature of the echo,calcification,as well as the boundary,from various aspects,such as internal blood flow condition for nodule provides the reference for the identification of the nature.(2)Compared with CNB,thyroid fine needle puncture has both safety and high diagnostic accuracy in operation and has been widely used in clinical practice.(3)Age,gender and other factors may also influence the identification of nodule properties.The comprehensive analysis of the ultrasonic characteristics of patients with nodules,combined with the medical history data and careful physical examination,and the rational application of FNA diagnosis technology,which has an important clinical value in the diagnosis of thyroid nodules disease.