Ultrasonographic Interval Changes in Solid Thyroid Nodules after Ultrasonography-Guided Fine-Needle Aspiration

Factors Influencing the Sample Adequacy of Ultrasound-Guided Fine-Needle Aspiration from Solid Thyroid Nodules for Liquid-Based Cytology: A Demographic, Sonographic, and Technical Perspective

Background and Objectives: To identify factors that influence the sample adequacy of solid thyroid nodules based on ultrasound-guided fine-needle aspiration (FNA) with subsequent liquid-based cytology. Materials and Methods: We retrospectively reviewed 855 patients who underwent ultrasound-guided FNA at our hospital between July 2019 and July 2020. The final analysis included 801 solid thyroid nodules in 801 patients. After reviewing the demographic data, ultrasonic features, and FNA technique-related factors, we defined 14 potential variables. For cytological results, the Bethesda categories II−VI were defined as adequate sample results. Univariate and multivariate analyses were performed to identify factors that influenced sample adequacy. Results: The adequate sample rate was 87.1%. The univariate analysis showed that four factors were related to adequate sampling in patients with thyroid FNA. These factors included age (p < 0.001), nodule orientation (p = 0.0232), calcification (p = 0.0034), and operator experience (p = 0.0286). After the multivariate analysis, five independent factors were identified to improve the diagnostic results of FNA for solid thyroid nodules: (1) the presence of Hashimoto’s thyroiditis (odds ratio (OR) = 1.810; 95% confidence interval (CI): 1.076−3.045; p = 0.0254), (2) a taller-than-wide orientation (OR = 2.038; 95% CI: 1.260−3.296; p = 0.0037), (3) the presence of calcification (OR = 1.767; 95% CI: 1.115−2.799; p = 0.0153), (4) four needle passes to obtain material (OR = 1.750; 95% CI: 1.094−2.799; p = 0.0196), and (5) an experienced operator (OR = 0.561; 95% CI: 0.319−0.987; p = 0.0451). Conclusions: A taller-than-wide orientation, the presence of calcification, and the presence of Hashimoto’s thyroiditis were found to affect the sample adequacy of ultrasound-guided FNA with liquid-based cytology. The sample adequacy could be improved when FNA is performed with four needle passes by experienced doctors.

Analysis of differences of ultrasound features in different courses of thyroid carcinoma

OBJECTIVE

To explore the changes of ultrasound features in patients with different courses of thyroid carcinoma, so as to provide a theoretical basis for the clinical treatment and diagnosis of thyroid carcinoma.

METHODS

A total of 160 patients with thyroid carcinoma treated in our hospital were enrolled and divided into the early stage group (n=76) and the advanced stage group (n=84) according to the results of pathological examination, and further grouped into the lymph node metastasis group (n=78) and the non-metastasis group (n=82). Another 80 patients with benign thyroid disease were enrolled as the benign group. All the enrolled subjects were subjected to ultrasound examination, and the differences of ultrasound features were compared between the different groups.

RESULTS

The average diameter of tumour and the proportion of nodular calcification and heterogeneous echo in the advanced stage group were significantly higher than those in the early stage group (P<0.05). The proportions of nodular calcification, heterogeneous echo, unsmooth margins, the aspect ratio of 1 or above, and irregular shapes in the malignant group were significantly higher than those in the benign group (P<0.05). The proportions of nodular calcification, heterogeneous echo, unsmooth margins, the aspect ratio of 1 or above, irregular shapes, multiple nodules, the largest diameter greater than 10 mm, rich blood flow, and absent halo in the lymph node metastasis group were significantly higher than those in the non-metastasis group (P<0.05).

CONCLUSION

There were significant differences of ultrasound features in the different courses of thyroid carcinoma. Ultrasound examination can provide important reference for later clinical diagnosis and treatment.

Ocular surface heat effects on ocular hemodynamics detected by real-time measuring device

AIM

To investigate the ocular hemodynamic effects of applying a hot compress to the eye.

METHODS

The right eyes of five New Zealand white rabbits, both male and female, were hot-compressed for 18min. An independently designed novel ocular contact-type temperature measuring device was used to measure the ocular surface temperature before and after the heating. Relevant retrobulbar hemodynamic parameters such as peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) of each of the central retinal artery (CRA), long posterior ciliary artery (LPCA), and ophthalmic artery (OA), as well as the mean velocity (V_m) of the central retinal vein (CRV), were measured using a color Doppler flow imaging (CDFI) technique and expressed as mean values with standard deviation (mean±SD). A statistical analysis was conducted based on a paired t-test and the Wilcoxon signed-rank test.

RESULTS

The employed real-time temperature measuring device was able to accurately measure ocular surface temperature during the hot-compress process. The temperature increased after the hot compress was applied. Analysis showed that the PSV and EDV values of the CRA and LPCA significantly increased after the application of the hot compress, as did the V_m of the CRV. There were no significant changes in the EDV of the OA nor the RI of each artery.

CONCLUSION

This experiment, which is the first of its kind, confirms that the retrobulbar blood flow velocities can increase upon heating the ocular surface. This simple method may be useful in the future.