Li Xiao-Long, Xu Hui-Xiong, Lu Feng, Yue Wen-Wen, Sun Li-Ping, Bo Xiao-Wan, Guo Le-Hang, Xu Jun-Mei, Liu Bo-Ji, Li Dan-Dan, Qu Shen
1 Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
2 Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
Br J Radiol. 2016;89(1059):20150858. doi: 10.1259/bjr.20150858. Epub 2016 Jan 22.
To evaluate the therapeutic efficacy and safety of ultrasound-guided percutaneous bipolar radiofrequency ablation (BRFA) of benign thyroid nodules by comparison with a matched untreated control group.
The therapeutic efficacy and safety in 35 patients who were subjected to a single session of ultrasound-guided percutaneous BRFA (Group A) for benign thyroid nodules were compared with those in 35 untreated patients (Group B) with benign nodules. The benign nature of all the nodules was confirmed by ultrasound-guided fine-needle aspiration biopsy (FNAB), and all the patients had normal thyroid functions. BRFA was performed with a bipolar electrode (CelonProSurge 150-T20) with an output power of 20 W. Nodule volume, thyroid function and clinical symptoms of all the patients were compared before treatment and during follow-up.
In Group A, the BRFA procedures were completed with a mean time of 10.02 ± 3.30 min (range, 5.47-16.03 min) and with a mean total energy deposition of 10.747 ± 3704 J (range, 5510-17.770 J). The procedures were tolerated well in all the patients without causing any major complications. At the 6-month follow-up, all of the nodule volume decreased significantly (from 8.81 ± 8.66 to 1.59 ± 1.55 ml, p < 0.001) in Group A, whereas the nodule volume increased from 6.90 ± 3.77 to 7.87 ± 3.95 ml in Group B (p < 0.001). All (100%) the 35 nodules in Group A had volume reduction ratios (VRRs) of >50%, among which 3 (8.57%) had VRRs >90%. In Group A, the clinical symptoms of the patients who had symptoms before BRFA disappeared, whereas in Group B, the patients had no resolution of clinical symptoms at the 6-month follow-up.
Ultrasound-guided percutaneous BRFA seems to be an effective and safe method for the treatment of benign thyroid nodules. It may gain a wide use in clinical practice.
Based on the comparable efficacy and clinical symptoms between the BRFA and untreated groups, the technique of BRFA can be used as an effective and safe method for the treatment of benign thyroid nodules.
通过与匹配的未治疗对照组比较，评估超声引导下经皮双极射频消融（BRFA）治疗良性甲状腺结节的疗效和安全性。
将35例接受单次超声引导下经皮BRFA治疗良性甲状腺结节的患者（A组）的疗效和安全性与35例未治疗的良性结节患者（B组）进行比较。所有结节的良性性质均通过超声引导下细针穿刺活检（FNAB）确诊，且所有患者甲状腺功能正常。使用输出功率为20W的双极电极（CelonProSurge 150-T20）进行BRFA。比较所有患者治疗前及随访期间的结节体积、甲状腺功能和临床症状。
A组BRFA手术平均时间为10.02±3.30分钟（范围5.47 - 16.03分钟），平均总能量沉积为10.747±3704焦耳（范围5510 - 17770焦耳）。所有患者对手术耐受性良好，未引起任何严重并发症。在6个月随访时，A组所有结节体积均显著减小（从8.81±8.66降至1.59±1.55毫升，p<0.001），而B组结节体积从6.90±3.77增至7.87±3.95毫升（p<0.001）。A组35个结节全部（100%）体积缩小率（VRR）>50%，其中3个（8.57%）VRR>90%。A组中BRFA前有症状的患者临床症状消失，而B组在6个月随访时患者临床症状未缓解。
超声引导下经皮BRFA似乎是治疗良性甲状腺结节的一种有效且安全的方法。它可能在临床实践中得到广泛应用。
基于BRFA组与未治疗组相当的疗效和临床症状，BRFA技术可作为治疗良性甲状腺结节的一种有效且安全的方法。
