Cervelli Rosa, Mazzeo Salvatore, De Napoli Luigi, Boccuzzi Antonio, Pontillo-Contillo Benedetta, Materazzi Gabriele, Miccoli Paolo, Cioni Roberto, Caramella Davide
Diagnostic and Interventional Radiology-Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy.
Diagnostic and Interventional Radiology-Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy.
J Vasc Interv Radiol. 2017 Oct;28(10):1400-1408. doi: 10.1016/j.jvir.2017.07.009. Epub 2017 Aug 24.
To evaluate the efficacy and safety of radiofrequency (RF) ablation in the treatment of benign thyroid nodules (BTNs) by applying a modification of the moving-shot technique.
Fifty-one BTNs in 46 patients for whom surgery was contraindicated or who refused surgery were treated with RF ablation: 31 had lesion volumes < 20 cm (group A) and 20 had volumes ≥ 20 cm (group B). The solid component percentage of each lesion was assessed, and any present fluid component was aspirated. Symptomatic scores and cosmetic scores (CSs) were assessed. All RF ablations were performed under ultrasound (US) guidance with an 18-gauge electrode. Treatment response was evaluated by contrast-enhanced US at 6-month intervals for 18 months in group A. In group B, after the 6- and 12-month follow-up assessments, a second treatment was performed in selected cases, and the 6-month contrast-enhanced US follow-up was started again. Volume reduction rate (VRR) was evaluated at each follow-up examination.
No permanent paralysis of the laryngeal nerve was observed; 2 patients experienced transient hoarseness. In all nodules treated with a single RF ablation session, the VRRs at 6, 12, and 18 months were 69.4%, 78.7%, and 84% in group A, respectively, and 66.6%, 79.4%, and 81.5% in group B, respectively. The VRRs of group B nodules treated with a second RF ablation procedure (n = 6) were 86.4% and 88.2% at 6 and 12 mo after the second treatment, respectively. All patients reported symptom relief and CS improvement.
RF ablation is a reliable alternative to surgery in patients affected by BTNs and can be safely repeated in selected cases.
通过应用改良的移动射击技术，评估射频（RF）消融治疗良性甲状腺结节（BTN）的疗效和安全性。
46例手术禁忌或拒绝手术的患者的51个BTN接受了RF消融治疗：31个病变体积<20 cm（A组），20个病变体积≥20 cm（B组）。评估每个病变的实性成分百分比，并抽吸任何存在的液体成分。评估症状评分和美容评分（CS）。所有RF消融均在超声（US）引导下使用18号电极进行。A组在18个月内每隔6个月通过超声造影评估治疗反应。B组在6个月和12个月的随访评估后，对选定病例进行第二次治疗，并再次开始6个月的超声造影随访。每次随访检查时评估体积缩小率（VRR）。
未观察到喉返神经永久性麻痹；2例患者出现短暂性声音嘶哑。在所有接受单次RF消融治疗的结节中，A组在6、12和18个月时的VRR分别为69.4%、78.7%和84%，B组分别为66.6%、79.4%和81.5%。接受第二次RF消融治疗的B组结节（n = 6）在第二次治疗后6个月和12个月时的VRR分别为86.4%和88.2%。所有患者均报告症状缓解且CS改善。
RF消融是BTN患者手术的可靠替代方法，在选定病例中可安全重复进行。
