Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, #388-1 Poongnap-2dong, Songpa-gu, Seoul, 138-736, Korea.
World J Surg. 2010 Jul;34(7):1488-93. doi: 10.1007/s00268-010-0565-6.
Although ethanol ablation (EA) is effective, refractory cases have been reported in 5-25% of patients, with a marked decline in efficacy on subsequent reattempt. The aim of this study was to evaluate the role of radiofrequency ablation (RFA) after EA of benign thyroid nodules in patients with incompletely resolved initial clinical problems.
Among 137 patients with 137 benign thyroid nodules who underwent EA, 27 patients (M:F = 5:22; mean age = 38 years, range = 21-60 years) underwent additional RFA if all of the following criteria were fulfilled: (1) complaint of incompletely resolved clinical problems, (2) demonstration of remaining solid component with internal vascularity on 1-month follow-up power Doppler US, and (3) patient desire for additional treatment. After RFA, there was improvement of clinical symptoms and characteristics and volume reduction of the treated nodules as seen on US; complications were evaluated at each follow-up.
The mean follow-up duration was 21.2 months (range = 6-38 months) after RFA. The mean symptom grading score of 10-cm visual analog scale, the mean cosmetic grading score on a 4-point scale, and the mean volume reduction of thyroid nodules were all significantly decreased from those seen before RFA (2.4-1.1, 3.7-1.5, and 4.2-1.1, respectively) (P < 0.05). There were no major complications.
RFA is an effective and safe method for treating benign thyroid nodules in patients with incompletely resolved clinical problems following EA.
虽然乙醇消融（EA）有效，但仍有 5-25%的患者报告出现难治性病例，且随后再次尝试时疗效明显下降。本研究旨在评估射频消融（RFA）在 EA 治疗后对初始临床问题未完全解决的良性甲状腺结节患者的作用。
在 137 例 137 个良性甲状腺结节患者中，27 例（M：F=5：22；平均年龄 38 岁，范围 21-60 岁）符合以下所有标准时行额外的 RFA：（1）有未完全解决的临床问题的主诉；（2）在 1 个月的随访彩色多普勒超声中显示仍有实性成分且内部有血管；（3）患者有额外治疗的愿望。在 RFA 后，临床症状和特征得到改善，治疗结节的体积通过超声减小；在每次随访时评估并发症。
RFA 后平均随访时间为 21.2 个月（范围 6-38 个月）。10cm 视觉模拟评分的平均症状分级评分、4 分制的美容分级评分和甲状腺结节的平均体积减少均显著低于 RFA 前（2.4-1.1、3.7-1.5 和 4.2-1.1）（P<0.05）。无重大并发症。
RFA 是治疗 EA 后临床问题未完全解决的良性甲状腺结节患者的有效且安全的方法。
