Paja Miguel, del Cura Jose L, Zabala Rosa, Corta Igone, Lizarraga Aitzol, Oleaga Amelia, Expósito Amaia, Gutiérrez M Teresa, Ugalde Aitziber, López José I
Department of Endocrinology, Basurto University Hospital, Bilbao, Spain.
Basque Country University, Bilbao, Spain.
Eur Radiol. 2016 Jan;26(1):1-8. doi: 10.1007/s00330-015-3821-1. Epub 2015 May 10.
To analyze the diagnostic accuracy of ultrasound-guided core-needle biopsy (CNB) of thyroid nodules.
Of 3517 CNBs performed using an 18G spring-loaded device in one institution, we retrospectively reviewed 676 nodules in 629 consecutive patients who underwent surgery. CNB and pathological examination were compared. CNB diagnosis was standardized in four categories: insufficient (I), benign (B), follicular lesion (FOL), and malignant (M). Main outcome measures were predictive positive values (PPV), false positives (FP), and false negatives (FN).
CNB showed a low rate of insufficient and FOL diagnoses (5.8 % and 4.5 %). On surgery, there were eight FNs in 374 benign CNBs and three FPs in 148 malignant CNBs. The 154 nodules classified as FOL in CNB included, at surgery, 122 neoplasms; 28 of them malignant. PPV for malignancy of a malignant CNB was 98 %, and for a CNB diagnosis of FOL 18.2 %. Sensitivity for malignancy if CNB of FOL and M are considered positive was 95.6. Only one major complication was observed.
CNB is reliable, safe, and accurate to evaluate thyroid nodules and can be an alternative technique to FNA. It has low rate of non-diagnostic and undetermined cases, with high sensitivity and PPV.
Thyroid core-needle biopsy (CNB) has high sensitivity and PPV. Pitfalls of CNB are rare. Pitfalls are due to cystic cancer, histological heterogeneity, and mistakes in analysis. CNB is a reliable, safe, and accurate method to approach thyroid nodules. CNB can be used primarily or after insufficient or indeterminate FNA.
分析超声引导下甲状腺结节粗针穿刺活检（CNB）的诊断准确性。
在一家机构中，对使用18G弹簧式活检装置进行的3517例CNB进行回顾性分析，我们回顾了629例连续接受手术的患者中的676个结节。比较CNB结果与病理检查结果。CNB诊断分为四类：取材不足（I）、良性（B）、滤泡性病变（FOL）和恶性（M）。主要观察指标为预测阳性值（PPV）、假阳性（FP）和假阴性（FN）。
CNB显示取材不足和FOL诊断率较低（分别为5.8%和4.5%）。手术中，374例良性CNB中有8例假阴性，148例恶性CNB中有3例假阳性。CNB分类为FOL的154个结节在手术中包括122个肿瘤，其中28个为恶性。恶性CNB诊断为恶性的PPV为98%，CNB诊断为FOL的PPV为18.2%。如果将FOL和M的CNB视为阳性，则对恶性肿瘤的敏感性为95.6%。仅观察到1例主要并发症。
CNB评估甲状腺结节可靠、安全且准确，可作为细针穿刺抽吸活检（FNA）的替代技术。其非诊断性和不确定病例发生率低，具有高敏感性和PPV。
甲状腺粗针穿刺活检（CNB）具有高敏感性和PPV。CNB的陷阱罕见。陷阱是由于囊性癌、组织学异质性和分析错误。CNB是一种可靠、安全且准确的甲状腺结节检查方法。CNB可在FNA取材不足或结果不确定时首先使用或在其之后使用。
