Jiang Danni, Zang Yichen, Jiang Dandan, Zhang Xiaojuan, Zhao Cheng
1 Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China.
2 Department of Breast Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
J Int Med Res. 2019 Feb;47(2):626-634. doi: 10.1177/0300060518807060. Epub 2018 Nov 21.
Application of rapid on-site evaluation (ROSE) for thyroid fine needle aspiration (FNA) is controversial. Therefore, ROSE has not been universally applied. This study aimed to evaluate the value of ROSE for ultrasound-guided thyroid FNA.
A total of 997 patients with 1103 suspicious thyroid nodules had ultrasound-guided FNA performed from January 2016 to February 2018. There were 513 nodules with ROSE and 590 nodules without ROSE. The cytological nondiagnostic rate, needle passes, and procedural times of thyroid FNA with or without ROSE were compared. The nondiagnostic rates of subsets of suspicious thyroid nodules were further compared.
There was no significant effect of ROSE on the nondiagnostic rate of FNA. However, FNA with ROSE significantly reduced the numbers of sub-centimeter, mixed solid-cystic, macrocalcified, and hypervascular nodules. There was a significantly smaller number of needle passes and less procedural times with ROSE than without ROSE. There was no significant difference in the complication rate of FNA with and without ROSE.
ROSE for thyroid FNA reduces the number of needle passes and procedural times. ROSE has a higher clinical application value in subsets of thyroid nodules, which tend to be difficult to diagnose with FNA.
快速现场评估(ROSE)在甲状腺细针穿刺抽吸活检(FNA)中的应用存在争议。因此,ROSE尚未得到广泛应用。本研究旨在评估ROSE在超声引导下甲状腺FNA中的价值。
2016年1月至2018年2月,对997例患者的1103个可疑甲状腺结节进行了超声引导下FNA。其中513个结节采用了ROSE,590个结节未采用ROSE。比较了采用或未采用ROSE的甲状腺FNA的细胞学诊断不明率、穿刺次数和操作时间。进一步比较了可疑甲状腺结节亚组的诊断不明率。
ROSE对FNA的诊断不明率没有显著影响。然而,采用ROSE的FNA显著减少了亚厘米级、混合实性-囊性、大钙化和高血管结节的数量。采用ROSE的穿刺次数和操作时间明显少于未采用ROSE的情况。采用和未采用ROSE的FNA并发症发生率没有显著差异。
甲状腺FNA采用ROSE可减少穿刺次数和操作时间。ROSE在甲状腺结节亚组中具有较高的临床应用价值,这些亚组的结节往往难以通过FNA进行诊断。