Опыт использования вакуумной тонкоигольной аспирационной биопсии под ультразвуковым контролем у пациентов с очаговой патологией щитовидной железы: пилотные результаты

Abstract

Background : Due to its availability, high information content and harmlessness, ultrasound is an extremely effective method of differential diagnosis of thyroid pathology. Despite the sufficient arsenal of diagnostic methods, thyroid biopsy with cytological examination is the «gold» standard in diagnostic algorithms. Most often, fine — needle aspiration biopsy is carried out using disposable syringes of different capacities (5, 10, 20 ml3). The procedure is performed in most cases according to the «Free hand» method, this leads to several problems associated with the peculiarity of the study, primarily with the low vacuum created in the syringe and insufficient collection of cytological material, as well as insufficient practical experience for a novice specialist. Aim: Determination of the range of the possibility of using vacuum aspiration fine needle biopsy under the control of ultrasound navigation in patients with focal thyroid pathology. Materials and methods : On the basis of the Problem Research Laboratory «Diagnostic studies and minimally invasive technologies» of the Smolensk State Medical University, a device for vacuum fine — needle aspiration biopsy was developed. In the period 2019–2020, 780 vacuum fine — needle aspiration biopsy was performed under the control of ultrasound navigation in patients with thyroid nodules. The level of vacuum in the syringe during sampling of the material was — 0,5 bar (- 50 kPa). Results: A comparative analysis of the cytological results obtained with the help of vacuum fine — needle aspiration biopsy and the «Free hand» method shows a decrease in obtaining the category of Bethesda 1 by 3.3% and Bethesda 3 by 10.2%. Conclusion: This indicates the effectiveness and in formativeness of the use of vacuum fine — needle aspiration biopsy in patients with focal thyroid pathology in comparison with the standard «Free hand» method, as well as with vacuum fine — needle aspiration biopsy due to constant visual monitoring and the lack of movement of the syringe piston to create a discharge when taking cytological material, the probability of needle deviation from the biopsy zone is reduced, which increases the effectiveness of the study and facilitates the work of a novice specialist.