Lim Hyun Kyung, Kim Dong Wook, Baek Jung Hwan, Huh Jung Yin, Ryu Ji Hwa, Sung Jin Yong, Park Sung Hee
a Department of Radiology , Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine , Seoul , South Korea.
b Department of Radiology , Busan Paik Hospital, Inje University College of Medicine , Busan , South Korea.
Endocr Res. 2018 May;43(2):65-72. doi: 10.1080/07435800.2017.1381973. Epub 2017 Oct 16.
The effect of ultrasonography (US)-guided fine-needle aspiration (US-FNA) for the collapse of benign cystic thyroid nodules is still unclear. This study aimed to assess the positive response rate following US-FNA of the cystic component of thyroid cysts and of partially cystic thyroid nodules (PCTNs), and to evaluate the factors influencing the outcome.
From June to December 2013, seven radiologists at seven institutions prospectively performed US-FNA on 320 cystic thyroid nodules in 320 patients. Among them, 179 underwent at least one follow-up US examination following US-FNA of the cystic component at each institution by the same radiologist. A variety of factors, including US features of cystic thyroid nodules, the characteristics of the aspirates, and the follow-up US findings, were analyzed.
Of 179 cystic thyroid nodules, there were 53 thyroid cysts and 126 PCTNs. Of 179 cystic thyroid nodules, no malignancies were detected. On follow-up US, the mean size reduction rate of the cystic component was 31.9%, and 102 out of 179 thyroid nodules (57.0%) were assigned to the response group. On univariate analysis, the degree of aspiration and time interval between US-FNA and the final follow-up US showed the significant differences between the response and no response groups. On multivariate analysis, the only factor that influenced the outcome was the nodule type. The cystic component's positive response rate after simple aspiration was higher in the thyroid cysts than in the PCTNs.
US-FNA may be effective at collapsing the cystic components of benign thyroid cysts and PCTNs.
超声(US)引导下细针穿刺抽吸(US-FNA)对良性甲状腺囊性结节塌陷的影响仍不明确。本研究旨在评估甲状腺囊肿及部分囊性甲状腺结节(PCTN)囊性成分经US-FNA后的阳性反应率,并评估影响结果的因素。
2013年6月至12月,7家机构的7名放射科医生对320例患者的320个甲状腺囊性结节进行了前瞻性US-FNA。其中,179例在各机构由同一名放射科医生对囊性成分进行US-FNA后至少接受了一次随访超声检查。分析了多种因素,包括甲状腺囊性结节的超声特征、抽吸物的特点以及随访超声检查结果。
179个甲状腺囊性结节中,有53个甲状腺囊肿和126个PCTN。179个甲状腺囊性结节均未检测到恶性肿瘤。随访超声检查显示,囊性成分的平均缩小率为31.9%,179个甲状腺结节中有102个(57.0%)被归入反应组。单因素分析显示,抽吸程度以及US-FNA与最终随访超声检查之间的时间间隔在反应组和无反应组之间存在显著差异。多因素分析显示,影响结果的唯一因素是结节类型。单纯抽吸后,甲状腺囊肿中囊性成分的阳性反应率高于PCTN。
US-FNA可能对良性甲状腺囊肿和PCTN的囊性成分塌陷有效。