甲状腺结节的冷冻微波消融：初步经验
Cooled microwave ablation of thyroid nodules: Initial experience.
作者信息
Korkusuz Yücel, Mader Oscar Maximilian, Kromen Wolfgang, Happel Christian, Ahmad Shadi, Gröner Daniel, Koca Mithat, Mader Alexander, Grünwald Frank, Korkusuz Hüdayi
机构信息
Department of Nuclear Medicine, University Hospital Frankfurt, Germany.
Department of Nuclear Medicine, University Hospital Frankfurt, Germany.
出版信息
Eur J Radiol. 2016 Nov;85(11):2127-2132. doi: 10.1016/j.ejrad.2016.09.019. Epub 2016 Sep 28.
OBJECTIVE
To evaluate if internally cooled microwave ablation (cMWA) is a safe and effective method for treatment of benign and malign thyroid nodules.
METHODS
9 patients with 11 symptomatic cold benign thyroid nodules and 1 recurrent thyroid carcinoma ranging in volume from 9.1 to 197ml (mean size 52± 57ml) were treated with cMWA. The mean age of the patients was 59 years. Pain during the treatment was measured on a 10-point scale. Side effects revealed by ultrasound or patients' complaints were documented. Periablative efficacy was measured 24h after cMWA as change (Δ) in serum thyreoglobulin (Tg). Nodule elasticity was measured on a 4-point scale, blood circulation and echogenicity on a 3-point scale.
RESULTS
All patients tolerated cMWA well. Median pain intensity averaged 2.1±0.8 (range: 1-3). Postablative hematoma was observed in all cases. In no cases ablation led to hoarseness, superficial burns, nodule ruptures, vagal reactions or dysphagia. cMWA lead to a significant decrease of blood circulation, nodule echogenicity and a significant increase of elasticity (Δ = 1.1 ± 0.33; 0.8 ± 0.4 and 1.1 ± 0.6 points)(p<0.05). An average increase of 4495ng/ml Tg was measured (p<0.05).
CONCLUSIONS
cMWA is an effective and secure method for treatment of thyroid nodules.
目的
评估内冷却微波消融术（cMWA）治疗良性和恶性甲状腺结节是否安全有效。
方法
对9例患有11个有症状的良性冷性甲状腺结节和1例复发性甲状腺癌的患者进行cMWA治疗，结节体积为9.1至197ml（平均大小52±57ml）。患者的平均年龄为59岁。治疗期间的疼痛采用10分制进行测量。记录超声检查发现的或患者主诉的副作用。在cMWA术后24小时测量消融周围的疗效，以血清甲状腺球蛋白（Tg）的变化（Δ）表示。结节弹性采用4分制进行测量，血液循环和回声性采用3分制进行测量。
结果
所有患者对cMWA耐受性良好。疼痛强度中位数平均为2.1±0.8（范围：1 - 3）。所有病例均观察到消融后血肿。无一例消融导致声音嘶哑、浅表烧伤、结节破裂、迷走神经反应或吞咽困难。cMWA导致血液循环、结节回声性显著降低，弹性显著增加（Δ = 1.1±0.33；0.8±0.4和1.1±0.6分）（p<0.05）。测得Tg平均升高4495ng/ml（p<0.05）。
结论
cMWA是治疗甲状腺结节的一种有效且安全的方法。
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