甲状腺术后床病变的核心针活检的诊断性能。
Diagnostic Performance of Core Needle Biopsy for Characterizing Thyroidectomy Bed Lesions.
机构信息
Department of Radiology, Hanyang University Medical Center, Hanyang University Medical College, Seoul, Korea.
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
出版信息
Korean J Radiol. 2022 Oct;23(10):1019-1027. doi: 10.3348/kjr.2021.0772. Epub 2022 Aug 31.
OBJECTIVE
Thyroidectomy bed lesions frequently show suspicious ultrasound (US) features after thyroid surgery. Fine-needle aspiration (FNA) may not provide definitive pathological information about the lesions. Although core-needle biopsy (CNB) has excellent diagnostic performance in characterizing suspicious thyroid nodules, no published studies have evaluated the performance of CNB specifically for thyroidectomy bed lesions. Therefore, we aimed to evaluate the diagnostic performance and safety of CNB for characterizing thyroidectomy bed lesions.
MATERIALS AND METHODS
A total of 124 thyroidectomy bed lesions in 113 patients (79 female and 34 male; age, 23-85 years) who underwent US-guided CNB between December 2008 and December 2020 were included. We reviewed the US imaging features of the target lesions and the histories of previous biopsies. The pathologic results, diagnostic performance for malignancy, and complications of CNB were analyzed.
RESULTS
All samples (100%) obtained by CNB were adequate for pathological analysis. Pathological analysis revealed inconclusive results in two lesions (1.6%). According to the reference standard, 50 lesions were ultimately malignant (40.3%), and 72 were benign (58.1%), excluding the two inconclusive lesions. The performance of CNB for diagnosing malignant thyroidectomy bed lesions in the 122 lesions had a sensitivity of 98.0% (49/50), a specificity of 100% (72/72), positive predictive value of 100% (49/49), and negative predictive value of 98.6% (72/73). Eleven lesions were referred for CNB after prior inconclusive FNA results in thyroidectomy bed lesions, for all of which CNB yielded correct conclusive pathologic diagnoses. According to the pathological analysis of CNB, there were various benign lesions (58.9%, 73/124) besides recurrence, including benign postoperative lesions other than suture granuloma (32.3%, 40/124), suture granuloma (15.3%, 19/124), remnant thyroid tissue (5.6%, 7/124), parathyroid lesions (4%, 5/124), and abscesses (1.6%, 2/124). No major or minor complications were associated with the CNB procedure.
CONCLUSION
US-guided CNB is accurate and safe for characterizing thyroidectomy bed lesions.
目的
甲状腺手术后，甲状腺床病变常表现出可疑的超声（US）特征。细针穿刺（FNA）可能无法提供病变的明确病理信息。虽然核心针活检（CNB）在诊断可疑甲状腺结节方面具有出色的诊断性能，但尚无研究专门评估 CNB 对甲状腺床病变的诊断性能。因此，我们旨在评估 CNB 对甲状腺床病变进行特征描述的诊断性能和安全性。
材料与方法
共纳入 2008 年 12 月至 2020 年 12 月期间 113 例（79 名女性和 34 名男性；年龄 23-85 岁）患者的 124 个甲状腺床病变进行了超声引导下 CNB。我们回顾了目标病变的 US 影像学特征和既往活检史。分析了 CNB 的病理结果、恶性肿瘤的诊断性能和并发症。
结果
所有 CNB 样本（100%）均适合进行病理分析。病理分析显示两个病变（1.6%）结果不确定。根据参考标准，50 个病变最终为恶性（40.3%），72 个为良性（58.1%），不包括两个不确定的病变。122 个甲状腺床病变中，CNB 诊断恶性病变的性能具有 98.0%（49/50）的灵敏度、100%（72/72）的特异性、100%（49/49）的阳性预测值和 98.6%（72/73）的阴性预测值。11 个病变在前次甲状腺床病变的不确定 FNA 结果后进行了 CNB 转诊，所有这些病变的 CNB 均得出了正确的明确病理诊断。根据 CNB 的病理分析，除复发外，还有各种良性病变（58.9%，73/124），包括缝线肉芽肿以外的良性术后病变（32.3%，40/124）、缝线肉芽肿（15.3%，19/124）、残留甲状腺组织（5.6%，7/124）、甲状旁腺病变（4%，5/124）和脓肿（1.6%，2/124）。CNB 过程中无重大或轻微并发症。
结论
超声引导下 CNB 准确、安全，可用于描述甲状腺床病变。
Zotero 插件