Yuav ua li cas cov thyroid nodular puncture puncture puncture immovable kom rov qab tau lub luag haujlwm
Nov 10, 2022
Tab sis tib lub sijhawm, biopsy kuj yog ib hom kev puas tsuaj rau lub cev, thiab tej zaum yuav muaj kev puas tsuaj, yog li thaum twg cov koob txhaj tshuaj zoo tau ua tiav? Cov hauv qab no yog kuv qhov kev taw qhia: Kev tswj xyuas cov thyroid nodule yuav tsum ua raws li cov txiaj ntsig ntawm ultrasound thiab FNA biopsy. Cov lus qhia tshiab hais tias cov thyroid ultrasound yuav tsum tau ua thaum cov neeg mob muaj kev pheej hmoo rau cov thyroid malignancy, muaj palpable nodules, multinodular goiters los yog loj lymph nodes nrog xav tias malignant lesions. Raws li cov txiaj ntsig kev ntsuam xyuas, txiav txim siab seb puas yog ultrasound-guided fine koob puncture biopsy yog tsim nyog. Nyob rau hauv tus txheej txheem ntawm kev kuaj ultrasound, FNA biopsy raug pom zoo rau cov nodules ua tau raws li cov hauv qab no: ① khoom hypoechoic nodules nrog ib txoj kab uas hla ntau dua 10 hli. ② Ultrasonography ntawm cov thyroid nodules ntawm ib tug loj npaum li cas nrog xav tias extracapsular loj hlob los yog ncauj tsev menyuam qog nqaij hlav metastasis. ③ Cov neeg mob uas muaj keeb kwm ntawm lub ncauj tsev menyuam raug hluav taws xob thaum yau lossis hluas; Thawj cov txheeb ze ntawm cov neeg mob uas muaj papillary thyroid carcinoma (PTC), medullary thyroid carcinoma (MTC), los yog ntau yam endocrine adenomatosis type 2 (MEN2); Keeb kwm ntawm thyroid cancer; Kev nce qib calcitonin ntsuas hauv qhov tsis muaj qhov cuam tshuam. (4) Nodules tsawg dua 10 mm nyob rau hauv txoj kab uas hla, tab sis ultrasonography pom cov tsos mob txuam nrog malignant lesions [hypoechoic thiab/los yog tsis xwm yeem ciam teb, slender duab, micro-calcification los yog cuam tshuam ntawm cov ntshav txaus teeb liab nyob rau hauv lub nodules]. Rau cov kab mob qog noj ntshav ntau ntau: ① Thaum cov nodules ua raws li cov cim qhia saum toj no ultrasound malignant, FNA biopsy tsis tshua xav tau ntau dua 2 nodules; ② FNA biopsy tsis tuaj yeem ua tau thaum "kub" nodules tau kuaj pom los ntawm isotope scanning. ③ Nyob rau hauv lub xub ntiag ntawm xav tias lymphadenopathy, FNA biopsy yuav tsum tau ua nyob rau hauv cov qog nqaij hlav loj thiab xav tias cov nodules ib txhij. Rau kev sib xyaw (khoom) cov thyroid nodules: ① UGFNA biopsy tau ua rau ntawm cov khoom ntawm cov nodules; ② Tib lub sijhawm, FNA biopsy kuaj thiab kuaj cov kua dej tau raug tshuaj xyuas cytologically. Rau cov qog nqaij hlav tsis sib haum xeeb: ① kev kho mob yuav tsum ua raws li cov txheej txheem kuaj mob ntawm cov thyroid nodules; ② Rau cov qog tsis npaj txhij pom los ntawm CT lossis magnetic resonance imaging (MRI), ultrasound yuav tsum tau ua ua ntej UGFNA. ③ Rau cov qog nqaij hlav raug kuaj pom los ntawm 18F-fluorodeoxyglucose-positron emission tomography (PET), vim muaj kev pheej hmoo ntawm malignancies, ultrasound thiab UGFNA yuav tsum tau ua ib txhij. Cov saum toj no tsis tsuas yog qhia txog qhov xav tau ntawm kev kuaj ntshav biopsy, tab sis kuj qhia rau peb paub qee qhov kev xav tau rau kev kuaj ntshav ntawm cov thyroid nodule kab mob, thiaj li ua tiav lub hom phiaj ntawm kev kuaj ntshav biopsy thiab qhov tseeb ntawm kev kuaj mob.
