Wu Wenjun, Gong Xiaohua, Zhou Qi, Chen Xiong, Chen Xiaojun, Shi Bimin
Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Endocr J. 2017 Nov 29;64(11):1079-1085. doi: 10.1507/endocrj.EJ17-0152. Epub 2017 Aug 29.
The aim of this study was to define the effectiveness and safety of ultrasound(US)-guided percutaneous microwave ablation(MWA) for benign thyroid nodules with one session treatment. A total 121 benign thyroid nodules in 100 euthyroid patients underwent MWA in one medical center between August 2014 and December 2015. MWA was performed with an internally cooled antenna under local anesthesia. The volume of the nodule, cosmetic score and symptom score were compared before and after the procedure. The volume reduction rate(VRR) was also evaluated. The side effects and complications were observed. As a result, microwave ablation was associated with a significant decrease in nodule volume{1.05±1.05mL (0.084.33mL)vs 8.56±4.21mL(4.0522.66mL), p <0.001} at 12-month follow-up. The largest diameter was also decreased {1.36±0.53cm(0.603.73cm) vs 2.94±0.55cm(2.004.40cm) , p<0.001}. The symptom score and cosmetic score were decreased significantly after the procedure(1.71±0.68 vs 3.31±1.13, p<0.001; 1.16±0.37 vs 2.37±0.94, p<0.001). The VRR was 57.66±22.95%, .70.23±20.07%, 85.97±14.04% at 3-, 6- and 12-month follow-up after ablation , respectively. Two patients(2.0%) experienced hoarseness and recovered within 2 months. Two patients(2.0%) developed slight burn on cervical skin. One case(1%) developed Horner Syndrome, recovered within 2 months. Ultrasound-guided percutaneous microwave ablation developed significant volume reduction on benign thyroid nodules, with achieving improvement in symptom score and cosmetic grading. The treatment was well tolerated.
本研究的目的是确定超声(US)引导下经皮微波消融(MWA)单次治疗良性甲状腺结节的有效性和安全性。2014年8月至2015年12月期间,在一个医疗中心,100例甲状腺功能正常的患者共121个良性甲状腺结节接受了MWA治疗。MWA在局部麻醉下使用内部冷却天线进行。比较手术前后结节的体积、美容评分和症状评分。还评估了体积缩小率(VRR)。观察副作用和并发症。结果,在12个月的随访中,微波消融使结节体积显著减小{1.05±1.05mL(0.084.33mL)对8.56±4.21mL(4.0522.66mL),p<0.001}。最大直径也减小了{1.36±0.53cm(0.603.73cm)对2.94±0.55cm(2.004.40cm),p<0.001}。手术后症状评分和美容评分显著降低(1.71±0.68对3.31±1.13,p<0.001;1.16±0.37对2.37±0.94,p<0.001)。消融后3个月、6个月和12个月随访时的VRR分别为57.66±22.95%、70.23±20.07%、85.97±14.04%。2例患者(2.0%)出现声音嘶哑,2个月内恢复。2例患者(2.0%)颈部皮肤出现轻微灼伤。1例患者(1%)出现霍纳综合征,2个月内恢复。超声引导下经皮微波消融使良性甲状腺结节体积显著缩小,症状评分和美容分级得到改善。该治疗耐受性良好。