Division of Thyroid and Endocrine Surgery, University Surgical Cluster, National University Health System (NUHS), NUHS Tower Block Level 8, Singapore, 119228, Singapore.
World J Surg. 2019 Aug;43(8):1957-1963. doi: 10.1007/s00268-019-04976-2.
High-intensity focused ultrasound (HIFU) is a recent noninvasive technique of treating thyroid nodules. Our study aims to investigate the efficacy and safety of HIFU in treating benign thyroid nodules.
This is a retrospective analysis of consecutive patients who underwent HIFU of benign thyroid nodules at our institution from July 2017-2018. All procedures were performed by a single surgeon. Patients were evaluated immediately post-procedure, and at subsequent intervals of 1 week, 1 month, 3 months, and 6 months. The primary endpoint was thyroid nodule volume reduction at 6 months posttreatment. Secondary endpoints were post-procedure local complications.
Ten patients with 13 thyroid nodules were included. The median follow-up period was 426 days (range 238-573). Mean maximum diameter reduced from 2.6 cm (±0.8) pretreatment to 1.4 cm (±0.7, P < 0.05) 6 months posttreatment. Mean nodule volume reduced from 5.2 cm (±4.2) pretreatment to 1.5 cm (±1.3, P = 0.01) 6 months posttreatment. Mean volume reduction ratio (VRR) at 6 months posttreatment was 63.2% (±22.5, P < 0.05), with volume reduction of ≥50% in 10 of 13 (76.9%) nodules. Two nodules (15.4%) showed size increases from 4 months posttreatment. No patients experienced local skin burns or hematomas. Mean pain scores were 1.5 (±1.2) immediate post-procedure, 0.8 (±1.5) at 1 week, and 0.6 (±1.2) at 1 month post-procedure, respectively, with no reports of pain beyond 1 month. Only two (20.0%) patients had early, temporary posttreatment voice hoarseness.
Our study shows HIFU ablation to be efficacious and safe-with significant thyroid nodule volume reductions, and no significant or prolonged local complications.
高强度聚焦超声（HIFU）是一种治疗甲状腺结节的新型非侵入性技术。本研究旨在探讨 HIFU 治疗良性甲状腺结节的疗效和安全性。
这是一项回顾性分析，纳入了 2017 年 7 月至 2018 年在我院接受 HIFU 治疗的良性甲状腺结节患者。所有手术均由一位外科医生完成。患者在术后即刻、术后 1 周、1 个月、3 个月和 6 个月进行评估。主要终点是治疗后 6 个月甲状腺结节体积缩小。次要终点是术后局部并发症。
10 例患者共 13 个甲状腺结节纳入研究。中位随访时间为 426 天（范围 238-573 天）。最大直径从治疗前的 2.6cm（±0.8）平均减少至治疗后 6 个月的 1.4cm（±0.7，P<0.05）。结节体积从治疗前的 5.2cm（±4.2）平均减少至治疗后 6 个月的 1.5cm（±1.3，P=0.01）。治疗后 6 个月体积减少率（VRR）为 63.2%（±22.5，P<0.05），13 个结节中有 10 个（76.9%）结节体积减少≥50%。2 个结节（15.4%）从治疗后 4 个月开始增大。无患者出现局部皮肤烧伤或血肿。术后即刻疼痛评分分别为 1.5（±1.2）、术后 1 周 0.8（±1.5）、术后 1 个月 0.6（±1.2），术后 1 个月后无疼痛报告。只有 2 例（20.0%）患者出现早期、暂时性的术后声音嘶哑。
本研究表明 HIFU 消融治疗安全有效，可显著缩小甲状腺结节体积，且无明显或长期的局部并发症。
