穿刺针型号及甲状腺结节血供类型与超声引导下细针穿刺活检取材满意率的关系

Relations of puncture needle gauge and type of vascularity of thyroid nodule with sample satisfaction rate of ultrasound-guided fine needle aspiration biopsy

目的:探讨影响甲状腺结节超声引导下细针穿刺活检(US-FNAB)取材满意率的因素,以及不同穿刺针型号与不同血供类型甲状腺结节类型对取材满意率的影响。方法:分析2015年6月—2017年9月行US-FNAB的310例甲状腺结节患者(共337例结节)的临床资料。分析取材满意率与穿刺针型号、结节血运类型及其他各因素的关系,并比较不同血管类型结节采用不同型号穿刺针满意率的差异。结果:337例甲状腺结节中,标本满意295例(87.5%),不满意42例(12.5%),统计分析结果显示,富血供结节标本不满意率升高(P=0.001),而穿刺针型号与其他因素均与取材满意率无明显关系(均P>0.05)。161例富血供结节中,采用23G与25G穿刺针的标本满意率分别为73.3%和88.4%(P<0.05);176例乏血供结节中,采用23G与25G穿刺针的标本满意率分别为96.8%和88.9%(P<0.05)。170例采用23G穿刺针的结节中,富血供与乏血供结节的标本满意率分别为73.3%和96.8%(P<0.05);167例采用25G穿刺针的结节中,富血供与乏血供结节标本满意率分别88.4%和88.9%(P>0.05)。结论:富血供类型结节更易造成取材不满意,细针型号对FNAB标本满意率没有明显影响,23G与25G均能满足US-FNAB检查需求,但23G穿刺针更宜应用于乏血供甲状腺结节,而25G穿刺针更宜应用于富血供甲状腺结节。

Objective: To investigate the factors affecting the sample satisfaction rate of ultrasound-guided fine needle aspiration biopsy (US-FNAB) of thyroid nodules, and the influences of different gauges of puncture needle and different types of vascularity of the thyroid nodule on the sample satisfaction rate. Methods: The clinical data of 310 patients with thyroid nodules (a total of 337 nodules) undergoing US-FNAB from June 2015 to September 2017 were analyzed. The relations of sample satisfaction rate with puncture needle gauge and type of vascularity of thyroid nodule as well as other factors were analyzed, and the differences in sample satisfaction rate of thyroid nodules with different vascularity using different gauges of puncture needle were also compared. Results: Among the 337 samples of nodules, 295 samples (87.5%) were satisfying, and 42 samples (12.5%) were not satisfying. Results of statistical analysis showed that the unsatisfaction rate in hypervascular nodule was significantly increased (P=0.001), but the puncture needle gauge and all other factors had no significant relation with sample satisfaction rate (all P>0.05). In the 161 samples of hypervascular nodule, the sample needles satisfaction rates by using 23G and 25G needles were 73.3% and 88.4%(P<0.05);in the 176 samples of hypovascular nodule, the satisfaction rates by using 23G and 25G needles were 96.8% and 88.9%(P<0.05). In the 170 samples drawn by 23G needle, the satisfaction rates for hypervascular and hypovascular nodule were 73.3% and 96.8%;in the 167 samples drawn by 25G needle, the satisfaction rates for hypervascular and hypovascular nodule were 88.4% and 88.9%(P>0.05). Conclusion: The hypervascular nodule is more likely to result in unsatisfied sample. The needle gauge has no obvious influence on the sample satisfaction rate of FNAB, and both 23G and 25G needles can meet the requirement of US-FNAB. However, the 23G needle is more suitable for the hypovascular nodules, and the 25G needle is more suitable for the hypervascular nodules.