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良性甲状腺结节的射频消融:236例患者的安全性及影像学随访

Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients.

作者信息

Jeong Woo Kyoung, Baek Jung Hwan, Rhim Hyunchul, Kim Yoon Suk, Kwak Min Sook, Jeong Hyun Jo, Lee Ducky

机构信息

Department of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea.

出版信息

Eur Radiol. 2008 Jun;18(6):1244-50. doi: 10.1007/s00330-008-0880-6. Epub 2008 Feb 20.

Abstract

This study evaluated the safety and volume reduction of ultrasonography (US)-guided radiofrequency ablation (RFA) for benign thyroid nodules, and the factors affecting the results obtained. A total of 302 benign thyroid nodules in 236 euthyroid patients underwent RFA between June 2002 and January 2005. RFA was carried out using an internally cooled electrode under local anesthesia. The volume-reduction ratio (VRR) was assessed by US and safety was determined by observing the complications during the follow-up period (1-41 months). The correlation between the VRR and several factors (patient age, volume and composition of the index nodule) was evaluated. The volume of index nodules was 0.11-95.61 ml (mean, 6.13 +/- 9.59 ml). After ablation, the volume of index nodules decreased to 0.00-26.07 ml (mean, 1.12 +/- 2.92 ml) and the VRR was 12.52-100% (mean, 84.11 +/- 14.93%) at the last follow-up. A VRR greater than 50% was observed in 91.06% of nodules, and 27.81% of index nodules disappeared. The complications encountered were pain, hematoma and transient voice changes. In conclusion, RFA is a safe modality effective at reducing volume in benign thyroid nodules.

摘要

本研究评估了超声(US)引导下射频消融(RFA)治疗良性甲状腺结节的安全性和体积缩小情况,以及影响治疗结果的因素。2002年6月至2005年1月期间,对236例甲状腺功能正常患者的302个良性甲状腺结节进行了RFA治疗。RFA在局部麻醉下使用内部冷却电极进行。通过超声评估体积缩小率(VRR),并通过观察随访期(1 - 41个月)内的并发症来确定安全性。评估了VRR与几个因素(患者年龄、靶结节体积和成分)之间的相关性。靶结节体积为0.11 - 95.61 ml(平均6.13±9.59 ml)。消融后,靶结节体积降至0.00 - 26.07 ml(平均1.12±2.92 ml),末次随访时VRR为12.52% - 100%(平均84.11±14.93%)。91.06%的结节VRR大于50%,27.81%的靶结节消失。出现的并发症有疼痛、血肿和短暂性声音改变。总之,RFA是一种安全的治疗方式,对缩小良性甲状腺结节的体积有效。

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