What are the pros and cons of thyroid nodule puncture?

Thyroid nodule puncture is actually to detect the presence of some diseases, such as thyroid nodules and thyroid tumors. In the process of thyroid nodule puncture, in fact, in addition to advantages, there are also certain disadvantages. The advantage is that it can detect the presence of tumors or nodules, and then provide timely professional treatment for the disease; the disadvantage of thyroid puncture is that it is easy to miss the diagnosis, and it may cause bleeding in the thyroid gland, affecting the examination. Patients should follow the doctor's advice on what kind of examination method to use so as to diagnose the disease more accurately.

What is a thyroid biopsy? Are there risks and side effects?

Thyroid puncture is performed to clarify the nature of nodules or tumors, including fine needle puncture and coarse needle puncture.

Fine needle aspiration

Contraindications: patients with bleeding tendency; highly sensitive patients; patients with systemic failure and intolerance; patients with local acute redness, swelling and inflammation or certain allergic reactions; nodules are too deep, poorly fixed, and too mobile; nodules are too small and puncture is difficult to succeed.

Indications: history of thyroid cancer; family history of thyroid cancer; nodules or swellings that cause compression or hoarseness, etc.

Advantages: can detect tumors, easy and fast operation, and can be punctured repeatedly.

Disadvantages: Single-point puncture is prone to missed diagnosis; it is difficult to differentiate between thyroid follicular carcinoma and follicular adenoma, chronic lymphocytic thyroiditis and thyroid lymphoma; bleeding may affect the examination, etc.

Core needle aspiration

Contraindications: Thyroid gland located too low; patients with mild enlargement; critically ill patients; patients with bleeding tendency.

Indications: Thyroid enlargement of grade II or above or larger nodules.

Advantages: easy to operate and relatively accurate diagnosis compared to fine needles.

Disadvantages: It causes great damage to the thyroid gland. Complications of fine needle puncture include bleeding, recurrent laryngeal nerve injury, infection, and thyroid fibrosis.

According to the clinical practice medical guidelines for the diagnosis and treatment of nodules issued by the American Association of Clinical Endocrinologists, the Italian Endocrine Society and the European Thyroid Association in 2010, ultrasound-guided fine needle aspiration (US-FNA) is recommended for nodules with a maximum diameter of 15 mm or more, or nodules smaller than 10 mm but suspected of malignancy clinically or by ultrasound. Puncture should be performed with caution in patients with coagulation disorders, long-term use of anticoagulants, and patients with abundant thyroid blood supply.