Uloga i značaj elastografije u dijagnostici diferentovanih karcinoma štitaste žlezde u odnosu na klinički, ehosonografski, biohumoralni i citološki pregled i korelacija nalaza sa definitivnim patohistološkim nalazima – Retrospektivna studija
Sažetak
Uvod/Cilj. Tiroidni nodusi predstavljaju veoma čest medicinski problem. Ultrazvučni pregled štitaste žlezde je najčešće primenjivana metoda za početnu procenu i izbor nodusa za iglenu biopsiju (fine needle aspiration biopsy – FNAB). Između mnogih metoda, ultrazvučna elastografija kao neinvazivna metoda ima veliki značaj u otkrivanja sumnjivih promena i određivanju prirode tumora. Pregled je potpuno bezbolan i jednostavan, a podrazumeva merenje
otpora mekih tkiva, kvalitativno i kvantitativno. Međutim, još uvek nije u potpunosti jasno u kojoj meri kvantitativni podaci dobijeni ultrazvučnom elastografijom korelišu sa podacima dobijenim drugim dijagnostičkim postupcima za detekciju toroidnih nodusa. Cilj studije bio je da se proceni značaj ultrazvučne elastografije u dijagnostici diferentovanih karcinoma štitaste žlezde, ali i vrednost drugih dijagnostičkih procedura. Metode. Istraživanje je obavljeno na bolesnicima koji su inicijalno upućeni u Kliniku za endokrinologiju Vojnomedicinske akademije u Beogradu u cilju evaluacije nodoznih struma. Korelisani su nalazi dobijeni elastografijom sa rezultatima kliničkog pregleda, biohumoralne, morfološke (ehosonografske), citološke obrade i definitivnog patohistološkog nalaza. Rezultati. Od svih praćenih parametara, statistički značajna razlika između dve grupe bolesnika sa folikularnim adenomom i diferentovanim tiroidnim karcinomom je detektovana za konzistenciju, nepokretnost nodusa, vrednost tiroglobulina (Tg), prisustvo solidnih nodusa, kalcifikata i elastografski skor. Nepokretni nodusi i oni tvrđe konzistencije su bili statistički značajno češće prisutni u grupi bolesnika sa malignim lezijama, gde je bila viša vrednost T). Elastografski skor 3–4 je pokazo visoku prediktivnu vrednost za detekciju tiroidnih karcinoma, za razliku od skora elasticiteta. Zaključak. Ultrazvučna elastografija predstavlja novu neinvazivnu metodu koja ima veoma značajnu, visoku prediktivnu vrednost za detekciju tiroidnih karcinoma, naročito u korelaciji sa drugim dijagnostičkim procedurama.
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