Chae In Hye, Kim Eun-Kyung, Moon Hee Jung, Yoon Jung Hyun, Park Vivian Y, Kwak Jin Young
Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Department of Radiology, National Cancer Center, Goyang, Republic of Korea.
Endocrine. 2017 Jul;57(1):108-114. doi: 10.1007/s12020-017-1319-0. Epub 2017 May 15.
To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma.
A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed.
Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P < 0.001). For ultrasound guided-fine needle aspiration, gender, age, size, presence of vascularity, and suspicious US features were not associated with post-biopsy hematoma according to experience level. Post-biopsy hematoma occurred significantly more with ultrasound guided-core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P < 0.001) in experienced performers and ultrasound guided-core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P < 0.001).
Post-biopsy hematoma occurred significantly more in ultrasound guided-core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.
比较超声引导下细针穿刺抽吸活检与超声引导下粗针穿刺活检后血肿发生率，并探讨活检后血肿的危险因素。
本回顾性研究纳入了5304个接受超声引导活检的甲状腺结节。我们比较了有活检后血肿和无活检后血肿患者的临床及超声特征。分析了这些特征与活检后血肿之间的关联。
超声引导下细针穿刺抽吸活检的活检后血肿发生率为0.8%（43/5121），超声引导下粗针穿刺活检的发生率为4.9%（9/183）（P＜0.001）。对于超声引导下细针穿刺抽吸活检，根据经验水平，性别、年龄、大小、血管情况及可疑超声特征与活检后血肿均无关联。在经验丰富的操作者中，超声引导下粗针穿刺活检后血肿的发生率（9/179，5.0%）显著高于超声引导下细针穿刺抽吸活检（9/1138，0.8%）（P＜0.001），且超声引导下粗针穿刺活检是活检后血肿的唯一显著危险因素（调整后的比值比为6.458，P＜0.001）。
超声引导下粗针穿刺活检后血肿的发生率显著高于超声引导下细针穿刺抽吸活检，且超声引导下粗针穿刺活检是甲状腺结节活检后血肿的唯一独立因素。
