Yoshimoto Kouichi, Satoh Shinya, Shindo Hisakazu, Katsuyama Kento, Tatsushima Daisuke, Fukuda Takashi, Tachibana Seigo, Mori Yusuke, Takahashi Hiroshi, Nagayama Yuji, Yamashita Hiroyuki
Department of Surgery, Yamashita Thyroid Hospital, Fukuoka, JPN.
Department of Endocrinology, Yamashita Thyroid Hospital, Fukuoka, JPN.
Cureus. 2024 Aug 16;16(8):e67033. doi: 10.7759/cureus.67033. eCollection 2024 Aug.
We aimed to determine whether early detection of acute transient thyroid swelling (ATTS) is possible using ultrasonography (US) surveillance immediately after fine-needle aspiration biopsy (FNAB) and discuss the usefulness of routine US after FNAB.
We retrospectively evaluated the incidence, clinical features, and US and computed tomography findings of ATTS in patients with thyroid nodules who underwent FNABs at our hospital. The study period was divided into two time periods: only symptomatic patients after FNAB were examined using US in the first period (period A: January 2016 to November 2020), whereas all patients were routinely examined using US shortly after FNAB in the second period (period B: December 2020 to December 2022).
We found that the frequency of ATTS increased from 0.18% (10/5,685) in period A to 1.58% (31/1,958) in period B because the majority of ATTS cases in period B were asymptomatic. Follow-up US performed 15 minutes to 3 hours later confirmed no exacerbation of thyroid swelling in patients diagnosed with ATTS during period B. Routine US examinations, shortly after FNAB, significantly reduced the number of return visits after discharge (from 5/10 to 2/31, p=0.006). Furthermore, the incidence of unilateral swelling was higher than previously reported.
Routine US examinations shortly after FNAB may be useful in identifying ATTS regardless of the presence of symptoms; moreover, they may reduce patients' return visits after leaving the hospital. It is also important to inform patients that delayed complications are possible and that severe cases, although rare, do exist.
我们旨在确定在细针穿刺活检（FNAB）后立即使用超声（US）监测是否能够早期检测急性短暂性甲状腺肿大（ATTS），并探讨FNAB后常规超声检查的实用性。
我们回顾性评估了在我院接受FNAB的甲状腺结节患者中ATTS的发生率、临床特征以及超声和计算机断层扫描结果。研究期分为两个时间段：在第一个时间段（A期：2016年1月至2020年11月），仅对FNAB后有症状的患者进行超声检查，而在第二个时间段（B期：2020年12月至2022年12月），所有患者在FNAB后不久均接受常规超声检查。
我们发现，ATTS的发生率从A期的0.18%（10/5685）增加到B期的1.58%（31/1958），因为B期的大多数ATTS病例无症状。在B期诊断为ATTS的患者中，15分钟至3小时后进行的随访超声检查证实甲状腺肿大没有加重。FNAB后不久进行的常规超声检查显著减少了出院后的复诊次数（从5/10降至2/31，p=0.006）。此外，单侧肿胀的发生率高于先前报道。
FNAB后不久进行常规超声检查可能有助于识别ATTS，无论有无症状；此外，还可能减少患者出院后的复诊次数。告知患者可能出现延迟并发症且确实存在严重病例（尽管罕见）也很重要。
