Park Hye Sun, Baek Jung Hwan, Choi Young Jun, Lee Jeong Hyun
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
Korean J Radiol. 2017 May-Jun;18(3):461-469. doi: 10.3348/kjr.2017.18.3.461. Epub 2017 Apr 3.
In the treatment of benign thyroid nodules, ethanol ablation (EA), and radiofrequency ablation (RFA) have been suggested for cystic and solid thyroid nodules, respectively. Although combining these ablation techniques may be effective, no guidelines for or reviews of the combination have been published. Currently, there are three ways of combining EA and RFA: additional RFA is effective for treatment of incompletely resolved symptoms and solid residual portions of a thyroid nodule after EA. Additional EA can be performed for the residual unablated solid portion of a nodule after RFA if it is adjacent to critical structures (e.g., trachea, esophagus, and recurrent laryngeal nerve). In the concomitant procedure, ethanol is injected to control venous oozing after aspiration of cystic fluid prior to RFA of the remaining solid nodule.
在良性甲状腺结节的治疗中，乙醇消融（EA）和射频消融（RFA）分别适用于囊性和实性甲状腺结节。尽管联合使用这些消融技术可能有效，但尚未发布关于该联合治疗的指南或综述。目前，EA和RFA联合使用有三种方式：额外的RFA对于治疗EA后未完全缓解的症状及甲状腺结节的实性残留部分有效。如果RFA后结节的残留未消融实性部分邻近关键结构（如气管、食管和喉返神经），则可对其进行额外的EA。在同步操作中，在对剩余实性结节进行RFA之前，先抽吸囊液，然后注射乙醇以控制静脉渗血。
