Ozcan Umit Aksoy, Atahan Safak
Department of Radiology, School of Medicine, Acibadem University, Istanbul, Turkey.
Patonet Cytopathology Laboratory, Bursa, Turkey.
Iran J Radiol. 2015 Apr 22;12(2):e8307. doi: 10.5812/iranjradiol.8307. eCollection 2015 Apr.
The goal of ultrasound guided fine-needle aspiration (USFNA) is to obtain most cellular specimen that represents the nodule. However, there is substantial variability in specimen cellularity depending on the obtaining techniques. While performing USFNA, it is not clear whether the needle tip should be placed at hypovascular or hypervascular site of the nodule to obtain more cells for cytological analysis.
The aim of the study was to assess whether USFNA of the hypovascular or hypervascular site of a thyroid nodule would reveal more cells for cytological analysis.
Twenty-three consecutive patients with solid thyroid nodules larger than 2 cm were aspirated under color Doppler sonography guidance. First pass was from the hypovascular site and the second pass from the hypervascular site. The aspirates were scored from 1-3 by cytologist according to number of cell groups.
When only hypervascular site was used, adequate sampling was limited to 65% of the cases. When both sites were evaluated together, overall adequate sampling was 91%. Adding a sample from the hypervascular site to hypovascular aspirate increased the adequate sampling by 8%. The highest pathological score was achieved when both hypo- and hypervascular site aspirates were evaluated together.
The aspirates from the hypovascular and hypervascular sites of solid nodules are complementary and should be performed consecutively.
超声引导下细针穿刺抽吸术（USFNA）的目标是获取最能代表结节的细胞标本。然而，根据获取技术的不同，标本的细胞含量存在很大差异。在进行USFNA时，尚不清楚针尖端应置于结节的低血管区还是高血管区，以获取更多细胞用于细胞学分析。
本研究旨在评估甲状腺结节低血管区或高血管区的USFNA是否能获取更多细胞用于细胞学分析。
在彩色多普勒超声引导下，对23例连续的实性甲状腺结节直径大于2 cm的患者进行抽吸。首次穿刺从低血管区进行，第二次穿刺从高血管区进行。细胞学家根据细胞团数量对抽吸物进行1-3分评分。
仅采用高血管区时，足够的采样仅限于65%的病例。当对两个区域一起评估时，总体足够采样率为91%。从高血管区添加样本到低血管区抽吸物可使足够采样率提高8%。当对低血管区和高血管区的抽吸物一起评估时，获得的病理评分最高。
实性结节低血管区和高血管区的抽吸物具有互补性，应连续进行。
