CABINET TESLA  —  MEDICAL IMAGING CENTER

Cognac Clinic  •  Dr Pierrick MORALES

Consent — Thyroid Fine-Needle Biopsy
71, Avenue d'Angoulème – 16100 Chateaubernard – COGNAC
Tel. : 05.45.35.68.91  •  Fax : 05.45.82.56.40  •  secretaire@radiologie-cognac.com
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ℹ️ Information about your examination — please read carefully ▼

Your doctor has proposed a radiological examination. It will be performed with your consent.
You are free to accept or refuse it.
To help you decide, please read the information provided below carefully.

What does the procedure involve?

This is a procedure in which a needle is used to take a sample from a thyroid nodule for cytological analysis.
Ultrasound does not use X-rays. It is a non-irradiating examination that uses the properties of sound waves.
At the power levels used, no harmful effects on humans have ever been reported.

How the procedure is performed:

The skin will always be disinfected first.
The needle will be guided by ultrasound and tracked on screen while you are lying down.

What complications could occur during the procedure?

Any intervention on the human body, even when performed under maximum conditions of skill and safety, carries a risk of complications.
As with any needle procedure, there is a small risk of localised bruising. The risk of more significant bleeding is higher in patients taking anticoagulants or aspirin.
To minimise the risk of bruising, pressure will be applied to the puncture site.
Infectious complications are extremely rare, given the strict aseptic conditions maintained.

What are the benefits of fine-needle biopsy?

Fine-needle biopsy allows a few cells to be taken from a thyroid nodule for analysis. If the result is sufficient, this can help avoid thyroid surgery; it also identifies suspicious nodules that require surgical removal.

Results

An initial comment may be given immediately after the procedure. This is only a preliminary assessment, as the samples must then be analysed by a pathologist.

The cytological analysis results will be sent directly to your doctor.

It is natural to have questions about the procedure. We hope we have answered them. Please feel free to ask us for any further information.

📋 Patient information

* Required: at least one 10-digit phone number and a valid email address.

⚠️ Please read each question carefully and correct if needed.

🩸 Blood conditions
1
Do you have a blood disorder or frequent/prolonged bleeding (e.g. nosebleeds)?
2
Do you have a blood-borne condition (hepatitis, HIV)?
💊 Anticoagulant / antiplatelet treatments
3
Are you taking a blood-thinning medication, anticoagulant or aspirin?
Aspirin, Plavix, Warfarin, Rivaroxaban, Apixaban…
⚠️ If yes, there is an increased risk of bleeding. Please inform the physician.
⚕️ Allergies
4
Do you have any allergies (medications, latex, other)?
As a general rule, please do not hesitate to provide any information you feel is important, and to tell us about any serious illness.
✍️ Patient consent

I, the undersigned, Mrs / Miss / Mr (delete as appropriate), certify that I have personally completed this form, have read and understood the information above, and give my consent for the procedure to be carried out. — NB: to be completed by a parent or guardian for minors.

Signature :

Sign in the box above