초음파 유도 하에 갑상선 결절 환자에 있어서 세침 생검과 수술 후 조직학적 결과 비교를 통한 초음파 유도 생검의 유용성

Abstract

Purpose: Fine needle aspiration biopsy (FNAB) is currently the most reliable test for the diagnosis of thyroid nodular disease. The purpose of this study was to compare of US-guided FNAB result with histopathologic finding after thyroidectomy for thyroid nodules and to access the usefulness of follow-up US-guided FNAB. Materials and Methods: US-guided FNAB was performed in 689 patients from March 2002 to June 2004. Thyroidectomies were performed in 99 of these patients. We compared the results for US-guided FNAB with post-operative histopathologic finding in these patients. All aspirations were performed with 21-guage needles attached to a 10-ml syringe with a syringe plunger. A high-frequency linear-array transducer was used for biopsies performed under ultrasound guidance. Results: A comparison of US-guided FNAB results with histopathologic findings after thyroidectomies was interpreted as 4(4%) false-positive and 6(6%) false-negative results. In the patients with FNAB results as indeterminate for malignancy, one patient had follicular carcinoma and another patient had papillary carcinoma on histopathologic analysis after thyroidectomies. One of 3 patients with nondiagnostic US-guided FNAB results were proved to micropapillary carcinoma on histopathologic findings after thyroidectomies. Conclusion: The main cause of false negative US-guided FNAB result was inadequate sampling by infracentimetric size. Follow- up US-guided FNAB will be necessary to decrease false negative US-guided FNAB results and improve the detection rate of malignant nodule.