- 期刊
彈性超音波檢查可有效減少甲狀腺良性結節接受細針抽吸的使用
US-elastography Can Reduce Thyroid Begin Lesion Accepted FNA
摘要
彈性超音波是一項新的檢查技術，此項功能可以偵測組織的軟硬度，因此有人稱它為電子觸診器或音波觸診器，本研究將此項技術應用於甲狀腺結節希望能對結節的良性與惡性診斷有助益，進而減少不必要的侵入性檢查或手術，同時在多個甲狀腺結節時，提供臨床醫師最有需要做細針抽吸(FNA)的介入性檢查的結節，以提升細針抽吸檢查的診斷率。本研究從2011年9月至2012年3月共收集202位受檢者，使用超音波掃描儀，以灰階(B-mode)超音波、彩色都卜勒超音波與彈性超音波檢查技術進行檢查，並將影像依文獻制定判讀標準進行統計分析比較，並提出結果希望能提供臨床醫師日後檢查時的參考依據。結果顯示灰階超音波可以輕易的發現結節，但無法辨識組織與結節的硬度，彩色都卜勒可以了解組織與結節血流分佈情形卻無法分辨結節的良性與惡性，彈性超音波無論彩色或黑白影像皆能提供甲狀腺結節的軟硬程度鑑別，對結節良性或惡性診斷很有幫助，若同時將三項技術相結合進行影像判讀將可減少44.5%(80/184)的良性結節不必接受侵入性檢查或手術，同時彈性超音波又能夠提供在多個甲狀腺結節時，何者是最有需要做侵入性細針抽吸(FNA)檢查，以提升該項檢查的診斷率。
並列摘要
Introduction: US-elastography is a new developed technique. Some people call it ＂electronic palpation device＂. We hope this technique facilitating differential diagnosis of thyroid nodules, reducing unnecessary interventional procedures or surgery, and furthermore, might identify which thyroid nodule is the available for fine-needle-aspiration (FNA). Material and Methods: From September, 2011 to March, 2012, 202 patients were recruited in this study at our hospital. We performed gray-scale ultrasound (B-mode), color Doppler ultrasound and US-elastogrphy for every patient. The images were interpreted and analyzed according to diagnostic criterion. We hope the result can help the physician in the management of thyroid nodules. Result: The result showed that gray-scale ultrasound (B-mode) can identify nodules easily, but it could not make out the hardness of tissue and nodules. Color Doppler showed the blood flow distribution of tissue and nodules, but it could not be applied to differentiate between malignant and benign nodules. Both gray scale and color images of elastography could show the hardness of nodule and differentiated malignant from benign nodules. Conclusion: In conclusion, we can reduce 44.5%(80/184) of benign nodules receiving unnecessary interventional examination or surgery via combining above three techniques. And the three combined methods might help to determine which nodule available for doing FNA.