Diagnostic Value Of Ultrasound Guided Core Needle Biopsy For Thyroid Nodules

Objective Ultrasound-guided core needle biopsy(CNB)was used as a firstline tool to examine suspicious thyroid nodules by ultrasound examination,evaluating its diagnostic value for thyroid nodules.Methods From October 2015 to November 2017,a total of 508 nodules were studied from 474 patients who underwent CNB in general surgery department of tianjin first central hospital.Thyroid cancers were finally diagnosed according to postoperative pathology,and the diagnosis of lymphoma was based on pathological findings of CNB.The diagnosis of benign nodules was based on postoperative pathology,or the results of continuous CNB were all benign(the puncture interval was at least 6 months),or the nodules showed no significant change or became smaller after at least 1 year of follow-up.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of CNB in thyroid cancer diagnosis were analyzed.The nondiagnostic rate of specimens,inconclusive rate and conclusive rate of CNB were calculated.The nodules were diagnosed as malignant nodules by CNB,but the final postoperative pathological findings indicated that they were benign lesions,the incidence of which was calculated,we called it the misdiagnosis rate.And the incidence of postoperative complications was calculated.The correlation between inconclusive diagnostic results and ultrasonic findings like echogenicity,internal structure,margin,calcification type,blood supply and nodule size was analyzed.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CNB for diagnosing of thyroid nodules were 97.27%,99.17%,99.07%,99.45% and 99.36%,respectively.However,the nondiagnostic rate,the conclusive rate,and the inconclusive rate of CNB were 2.95%,92.92% and7.09%,respectively.The misdiagnosis rate of CNB was 1.86%.In addition,there was no statistically significant difference in ultrasonic characteristics of echogenicity,internal structure,margin,and blood supply between inconclusive and conclusive diagnostic results of CNB,but there was significant difference in calcific type and nodule size,and the difference was statistically significant(p<0.05).No serious complications occurred in all patients who underwent CNB,and a total of 3 patients had minor complications.Conclusion Ultrasound guided core needle biopsy has high sensitivity,specificity,positive predictive value,negative predictive value and accuracy for determining the nature of thyroid nodules,and has a low incidence of complication.Therefore,it can be considered as the preferred examination method for determining the nature of thyroid nodules.