Prediction of hemorrhagic complications after ultrasound-guided biopsy of the thyroid and neck

Abstract

© 2022, The Author(s), under exclusive licence to European Society of Radiology.Objectives: Hemorrhage occasionally occurs after ultrasound (US)-guided biopsy of the thyroid and neck and sometimes leads to serious complications. We aimed to identify predictors of hemorrhagic complications after US-guided biopsy of the thyroid and neck. Material and methods: In this retrospective study, we analyzed consecutive patients who underwent US-guided biopsy from April 2020 to November 2020. Procedure characteristics, US features, and peri- and post-procedural patient symptoms and signs were compared between patients with and without post-biopsy hemorrhage. Associations between clinical and imaging variables and post-biopsy hemorrhage were analyzed using univariate and multivariate regression analyses. Results: A total of 305 patients who underwent US-guided biopsy of the thyroid and neck were included (219 women, 86 men; age range, 20–89 years). Seventeen (5.7%) cases of post-biopsy hemorrhage were detected 30 min after biopsy and manual compression. Among them, 10 developed hemorrhage at 30 min without immediate hemorrhage. In the multivariate analysis, a high tenderness score on the visual analog scale (VAS) at 30 min after biopsy (odds ratio [OR] 5.05, p <.001) was identified as an independent predictor of post-biopsy hemorrhage. In patients with hemorrhage at 30 min, tenderness scores significantly increased over 30 min of observation. Conclusions: High tenderness scores at 30 min after biopsy and manual compression were independent predictors of hemorrhage after US-guided biopsy of the thyroid and neck. The tenderness score could serve as a valuable marker to triage patients who require further observation and management after a US-guided biopsy of the thyroid and neck. Key Points: • High tenderness scores at 30 min after compression were associated with the presence of delayed post-biopsy hemorrhage at 30 min. • Patients with hemorrhage at 30 min demonstrated a significant increase in tenderness scores over time. • High tenderness scores after biopsy site compression predicted the presence of delayed post-biopsy hemorrhage in the thyroid and neck.