Kim Yong Hee, Kwon Hyeong Ju, Kim Eun-Kyung, Kwak Jin Young, Moon Hee Jung, Yoon Jung Hyun
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea (Y.H.K., E.-K.K., J.Y.K., H.J.M., J.H.Y.); and Department of Pathology, Yonsei University, College of Medicine, Seoul, Korea (H.J.K.).
J Ultrasound Med. 2015 Oct;34(10):1801-8. doi: 10.7863/ultra.15.14.12028. Epub 2015 Aug 31.
The purpose of this study was to investigate the level of conclusive results obtained with ultrasound (US)-guided core needle biopsy (CNB) and how this method should be applied for diagnosis of thyroid nodules.
From January 2013 to November 2014, US-guided CNB was performed in 84 thyroid lesions of 83 patients. Based on CNB pathologic reports, thyroid nodules were divided into 2 categories: conclusive (nodules reaching a definite pathologic diagnosis suggesting benignity or malignancy) and inconclusive (nodules that were not able to reach a definite diagnosis because of ambiguous results). Medical records and US examinations were reviewed and compared.
The mean age of the 83 patients ± SD was 49.7 ± 14.1 years. Of the 84 thyroid nodules, 73 (86.9%) were diagnosed as benign or malignant and 11 (13.1%) as inconclusive by CNB pathologic analysis. Among the 11 nodules with inconclusive results, the possibility of a follicular neoplasm was suggested in 8 nodules (72.7%). No significant difference was seen in tumor size and US features when comparing the nodules with conclusive and inconclusive results (all P >.05).
Ultrasound-guided CNB may have supplemental roles in addition to US-guided fine-needle aspiration for diagnosis of selected cases. A considerable proportion of inconclusive results are seen on US-guided CNB, especially for diagnosis of follicular lesions, which must be considered when using this method for diagnosis of thyroid nodules.
本研究旨在调查超声（US）引导下的粗针穿刺活检（CNB）所获得的确切结果水平，以及该方法应如何应用于甲状腺结节的诊断。
2013年1月至2014年11月，对83例患者的84个甲状腺病变进行了US引导下的CNB。根据CNB病理报告，将甲状腺结节分为2类：确诊（结节达到明确的病理诊断，提示良性或恶性）和不确定（由于结果不明确而无法得出明确诊断的结节）。回顾并比较病历和超声检查结果。
83例患者的平均年龄±标准差为49.7±14.1岁。84个甲状腺结节中，经CNB病理分析，73个（86.9%）被诊断为良性或恶性，11个（13.1%）为不确定。在11个结果不确定的结节中，8个结节（72.7%）提示有滤泡性肿瘤的可能性。比较确诊和不确定结果的结节时，在肿瘤大小和超声特征方面未见显著差异（所有P>.05）。
除US引导下的细针穿刺抽吸外，超声引导下的CNB在某些特定病例的诊断中可能具有辅助作用。超声引导下的CNB可见相当比例的不确定结果，尤其是在滤泡性病变的诊断中，使用该方法诊断甲状腺结节时必须考虑到这一点。
