甲状腺超声检查因其具有无创、高效、经济等优势,已成为甲状腺结节的首选检查方法.甲状腺结节检出后的核心问题是评估结节性质,甄别恶性高风险结节.超声引导下对甲状腺结节进行穿刺活检取材,结合细胞学病理检查结果是目前判断甲状腺结节性质的首选方法,是实现甲状腺结节全程管理的重要途径.目前细针穿刺活检在甲状腺结节的诊断中应用广泛,由于细针穿刺取材有限的缺点,限制了诊断效能.粗针穿刺活检可以获得更多的组织学信息,比细针穿刺单纯依靠细胞学诊断更具优势,已被提出作为术前诊断甲状腺结节的补充方法甚至是替代方法.本文通过查阅文献,总结粗针穿刺活检在甲状腺结节恶性风险评估中的基本概况、适应证、组织学病理报告系统、并发症等做一综述,以期为甲状腺结节检出后穿刺方式的选择提供参考依据.
Thyroid ultrasound is preferred to the examination of thyroid nodules due to its non-invasive,economical,and accurate advantages.The key events for detecting thyroid nodules were the evaluation of the nature of the nodules and identification of high-risk malignant nodules.Ultrasound-guided puncture biopsy of thyroid nodules combined with cytological and pathological examination results was currently the preferred method for determining the nature of thyroid nodules,which was an important way to achieve the whole-process management of thyroid nodules.At present,fine needle aspiration has been widely used in the diagnosis of thyroid nodules.Due to the shortcomings of limited sampling material,the diagnostic efficiency was relatively low.Core needle biopsy can obtain more histological information,possessing more advantages than fine needle aspiration that solely relies on cytology diagnosis.It has been proposed as a supplementary or even alternative method for preoperative diagnosis of thyroid nodules.This article summarizes the basic overview,indications,histopathological reporting system,and complications of core needle biopsy in the risk assessment of malignant thyroid nodules through literature review,thus providing references for selecting the optimal puncture methods after thyroid nodule detection.