Zhou W, Zhang L, Zhan W, Jiang S, Zhu Y, Xu S
Department of Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Clin Radiol. 2016 Dec;71(12):1233-1239. doi: 10.1016/j.crad.2016.07.010. Epub 2016 Aug 21.
To evaluate the efficacy and safety of ultrasound-guided percutaneous laser ablation (PLA) for recurrent papillary thyroid carcinomas (PTC) <15 mm in the neck.
A retrospective study was conducted in 21 patients with 27 recurrent PTC lesions who underwent PLA. The extent of ablation was assessed by contrast-enhanced ultrasonography (CEUS) after PLA. Measurement of the volume of tumour and serum thyroglobulin, and clinical evaluation were performed at 7 days, and 1, 3, 6, and 12 months, and every 6 months thereafter.
The procedure was well tolerated. Of 21 patients, 18 were successfully treated in a single session. Incomplete ablation was detected by CEUS in three patients, and a second ablation was performed. The mean largest diameter and the average baseline volume were reduced from 7.5±2.8 mm and 105.4±114 mm to 0.4±1 mm and 0.8±2.4 mm at the final follow-up.
Ultrasound-guided PLA is effective for the treatment of recurrent PTCs with a comparable success rate to radio-iodine therapy, and it may become a primary choice of treatment for recurrent PTCs in selected patients who are ineligible for surgery and/or prefer not to have further surgery.
评估超声引导下经皮激光消融术（PLA）治疗颈部直径<15mm的复发性甲状腺乳头状癌（PTC）的疗效和安全性。
对21例患有27个复发性PTC病灶并接受PLA治疗的患者进行回顾性研究。PLA术后通过超声造影（CEUS）评估消融范围。在术后7天、1个月、3个月、6个月、12个月以及之后每6个月测量肿瘤体积和血清甲状腺球蛋白，并进行临床评估。
该手术耐受性良好。21例患者中，18例单次治疗成功。3例患者经CEUS检测发现消融不完全，遂进行了二次消融。末次随访时，平均最大直径和平均基线体积分别从7.5±2.8mm和105.4±114mm降至0.4±1mm和0.8±2.4mm。
超声引导下PLA治疗复发性PTC有效，成功率与放射性碘治疗相当，对于不适合手术和/或不愿接受进一步手术的特定患者，它可能成为复发性PTC的主要治疗选择。
