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超声引导经皮微波消融治疗良性甲状腺结节:222 例患者的安全性和影像学随访。

Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients.

机构信息

Binzhou Medical University, #346 Guan-hai Road, Lai-shan, Yantai, Shandong 264003, PR China.

出版信息

Eur J Radiol. 2013 Jan;82(1):e11-6. doi: 10.1016/j.ejrad.2012.07.020. Epub 2012 Aug 30.

Abstract

OBJECTIVE

Microwave ablation is a minimally invasive technique that has been used to treat benign and malignant tumors of liver, lung and kidney. Towards thyroid nodules, only a few cases are reported so far. The aim of the study was to investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules with a large sample.

MATERIALS AND METHODS

A total of 477 benign thyroid nodules in 222 patients underwent microwave ablation in our department from July 2009 to March 2012. Microwave ablation was carried out using microwave antenna (16G) under local anesthesia. Nodule volume, thyroid function and clinical symptoms were evaluated before treatment and at 1, 3, more than 6 months. The study was ethics committee approved and written informed consents were obtained from all patients.

RESULTS

All thyroid nodules significantly decreased in size after microwave ablation. A 6-month follow-up was achieved in 254 of 477 nodules, and the mean decrease in the volume of thyroid nodules was from 2.13 ± 4.42 ml to 0.45 ± 0.90 ml, with a mean percent decrease of 0.65 ± 0.65. A volume-reduction ratio greater than 50% was observed in 82.3% (209/254) of index nodules, and 30.7% (78/254) of index nodules disappeared 6-month after the ablation. The treatment was well tolerated and no major complications were observed except pain and transient voice changes.

CONCLUSIONS

Microwave ablation seems to be a safe and effective technique for the treatment of benign thyroid nodules. Further prospective randomized studies are needed to define the role of the procedure in the treatment of thyroid nodules.

摘要

目的

微波消融是一种微创技术,已被用于治疗肝、肺和肾的良性和恶性肿瘤。对于甲状腺结节,目前仅报道了少数病例。本研究旨在探讨超声引导经皮微波消融治疗大样本良性甲状腺结节的有效性和安全性。

材料和方法

2009 年 7 月至 2012 年 3 月,我科共对 222 例 477 个良性甲状腺结节患者进行了微波消融。在局部麻醉下使用微波天线(16G)进行微波消融。在治疗前和治疗后 1、3、6 个月以上评估结节体积、甲状腺功能和临床症状。本研究经伦理委员会批准,并获得所有患者的书面知情同意。

结果

所有甲状腺结节经微波消融后均显著缩小。477 个结节中有 254 个获得了 6 个月的随访,甲状腺结节体积的平均缩小量从 2.13±4.42ml 到 0.45±0.90ml,平均缩小率为 0.65±0.65。82.3%(209/254)的指数结节体积减少率大于 50%,78/254(30.7%)的指数结节在消融后 6 个月消失。除疼痛和短暂性声音改变外,治疗耐受性良好,未观察到重大并发症。

结论

微波消融似乎是治疗良性甲状腺结节的一种安全有效的技术。需要进一步的前瞻性随机研究来确定该程序在治疗甲状腺结节中的作用。

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