Sung Jin Yong, Baek Jung Hwan, Kim Yoon Suk, Jeong Hyun Jo, Kwak Min Sook, Lee Ducky, Moon Won-Jin
Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital, 978-13 Daerim-dong, Youngdeunpo-gu, Seoul, 150-070 Korea.
AJR Am J Roentgenol. 2008 Dec;191(6):1730-3. doi: 10.2214/AJR.08.1113.
The purpose of this study was to evaluate the efficacy and safety of one-step ethanol ablation in the management of viscous cystic thyroid nodules.
Viscous cystic thyroid nodules are defined as nodules that cannot be aspirated with an 18-gauge needle. Nine euthyroid patients underwent one-step ethanol ablation of benign single compressive viscous cystic thyroid nodules (cystic portion > 90%). The thick content of the nodules was removed with either a 16-gauge needle (n = 8) or an 8.5-French pigtail catheter (n = 1) connected to a suction pump. An injection of 99% sterile ethanol then was administered. After 10 minutes, all of the injected ethanol was withdrawn. Additional treatment was prescribed if the cystic portion of the nodule remained larger than 1 mL. Follow-up sonography was performed 1 and 6 months after treatment. At each follow-up examination, nodule volume, symptom score (centimeter visual analog scale, 0-10), cosmetic grade (grade 1-4), and complications were evaluated.
The mean volume of index nodules was 24.4 +/- 20.3 (SD) mL (range, 4.5-57.4 mL). The mean amount of ethanol injected was 11.8 +/- 10.1 mL (range, 2-27 mL). The mean total procedure time was 27.8 +/- 10.4 minutes (range, 15-45 minutes). One month after ablation, the mean volume of the nodules had decreased significantly (7.2 +/- 9.4 vs 24.4 +/- 20.3 mL, p = 0.008). Additional reduction was found at the 6-month follow-up examination, the mean nodule volume being 2.1 +/- 3.8 mL (p = 0.008). The mean volume reductions at 1 and 6 months were 78.4% +/- 14.4% and 93.6% +/- 6.8%. The mean symptom score decreased from 3.2 +/- 1.5 to 0.4 +/- 1.0 (p < 0.05) and the mean cosmetic grade from 3.9 +/- 0.3 to 1.3 +/- 0.7 (p < 0.05). No major complications were encountered.
One-step ethanol ablation is an effective and safe method of management of viscous cystic thyroid nodules.
本研究旨在评估一步乙醇消融术治疗粘性囊性甲状腺结节的疗效和安全性。
粘性囊性甲状腺结节定义为无法用18号针抽吸的结节。9例甲状腺功能正常的患者接受了良性单发压迫性粘性囊性甲状腺结节（囊性部分>90%）的一步乙醇消融术。用连接抽吸泵的16号针（n = 8）或8.5法式猪尾导管（n = 1）清除结节的浓稠内容物。然后注射99%的无菌乙醇。10分钟后，将所有注入的乙醇抽出。如果结节的囊性部分仍大于1 mL，则进行额外治疗。治疗后1个月和6个月进行超声随访。每次随访时，评估结节体积、症状评分（厘米视觉模拟量表，0 - 10）、美容等级（1 - 4级）和并发症。
索引结节的平均体积为24.4±20.3（标准差）mL（范围4.5 - 57.4 mL）。注入乙醇的平均量为11.8±10.1 mL（范围2 - 27 mL）。总操作时间平均为27.8±10.4分钟（范围15 - 45分钟）。消融后1个月，结节的平均体积显著减小（7.2±9.4 vs 24.4±20.3 mL，p = 0.008）。在6个月的随访检查中发现进一步缩小，平均结节体积为2.1±3.8 mL（p = 0.008）。1个月和6个月时的平均体积缩小分别为78.4%±14.4%和93.6%±6.8%。平均症状评分从3.2±1.5降至0.4±1.0（p < 0.05），平均美容等级从3.9±0.3降至1.3±0.7（p < 0.05）。未出现重大并发症。
一步乙醇消融术是治疗粘性囊性甲状腺结节的一种有效且安全的方法。
