Livraghi T, Paracchi A, Ferrari C, Bergonzi M, Garavaglia G, Raineri P, Vettori C
Department of Radiology, Ospedale Civile, Milan, Italy.
Radiology. 1990 Jun;175(3):827-9. doi: 10.1148/radiology.175.3.2188302.
Eight patients with autonomous thyroid nodules 2.4-4.3 cm in diameter received percutaneous ethanol injections (PEIs) under guidance by means of ultrasound (US). Sterile ethanol at 95% was injected with a 22-gauge needle and a 7.5-MHz probe with a guide device. Each patient received one or two treatments, with 1-3 mL of alcohol (depending on the nodule size) per treatment, each week for a total of three to six injections per lesion. After a total of 36 injections in all eight patients, there were no complications. Follow-up ranged from 2 to 10 months. After therapy, symptoms subsided and hormonal levels became normal or reached the range of subclinical hypothyroidism. Scintigrams showed that the previously suppressed thyroid tissue had resumed functioning. At US, all nodules had shrunk. PEI was risk free and easy to perform. If these preliminary results are confirmed in a larger study with longer follow-up, the new treatment may become an alternative to surgical or radioiodine ablation of autonomous thyroid nodules.
8例直径为2.4 - 4.3厘米的自主性甲状腺结节患者在超声引导下接受了经皮乙醇注射(PEI)治疗。使用22号针头和带有引导装置的7.5兆赫探头注射95%的无菌乙醇。每位患者接受1或2次治疗,每次治疗注射1 - 3毫升乙醇(取决于结节大小),每周1次,每个病灶共注射3至6次。8例患者总共注射36次后,未出现并发症。随访时间为2至10个月。治疗后,症状消退,激素水平恢复正常或达到亚临床甲状腺功能减退范围。闪烁扫描显示,先前受抑制的甲状腺组织已恢复功能。超声检查显示,所有结节均已缩小。经皮乙醇注射无风险且操作简便。如果这些初步结果在一项随访时间更长的大型研究中得到证实,这种新治疗方法可能会成为自主性甲状腺结节手术或放射性碘消融的替代方法。