Rabuffi Paolo, Spada Antonio, Bosco Daniela, Bruni Antonio, Vagnarelli Simone, Ambrogi Cesare, Di Stasio Enrico, Santonati Assunta
Department of Interventional Radiology, San Giovanni Addolorata Hospital, Rome, Italy.
Department of Endocrinology, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy.
J Ultrasound. 2019 Jun;22(2):193-199. doi: 10.1007/s40477-019-00375-4. Epub 2019 Apr 3.
The aim of this study is to assess the effectiveness and safety of radiofrequency ablation (RFA) in debulking benign solid thyroid nodules.
This is a retrospective review of 77 patients with predominantly solid thyroid nodules treated with RFA in a single center between 2013 and 2016. All patients declined or were not eligible for surgery. Benign proven thyroid nodules causing compressive symptoms and cosmetic concerns were considered for treatment. Nodule volume, thyroid nodule related compressive symptoms, cosmetic concerns and thyroid function were evaluated.
All patients underwent a single treatment session. Mean nodule volume decreased from 17.9 ± 15.6 mL at baseline to 5.2 ± 7.4 after 12 months with a volume reduction ratio (VRR) of 70.9% ± 20.8%. There were no identifiable factors predictive of response to RFA. Median cosmetic and symptom scores of the entire population decreased from 3 [2-4] and 3 [0-10] to 1 [1-3] (p < 0.001) and 0 [0-5] (p < 0.001), respectively. No major complications occurred and RFA did not affect thyroid function when normal.
RFA induces substantial volume reduction of predominantly solid thyroid nodules and improves compressive symptoms and cosmetic concerns. RFA does not impact normal thyroid function and has an acceptable safety profile.
本研究旨在评估射频消融术（RFA）在缩小良性实性甲状腺结节体积方面的有效性和安全性。
这是一项对2013年至2016年间在单一中心接受RFA治疗的77例以实性甲状腺结节为主的患者的回顾性研究。所有患者均拒绝手术或不适合手术。引起压迫症状和影响美观的经病理证实的良性甲状腺结节被纳入治疗。评估结节体积、甲状腺结节相关压迫症状、美观问题和甲状腺功能。
所有患者均接受了单次治疗。平均结节体积从基线时的17.9±15.6 mL降至12个月后的5.2±7.4 mL，体积缩小率（VRR）为70.9%±20.8%。没有可识别的预测RFA反应的因素。整个人群的美观评分中位数从3[2 - 4]降至1[1 - 3]（p < 0.001），症状评分中位数从3[0 - 10]降至0[0 - 5]（p < 0.001）。未发生重大并发症，且RFA在甲状腺功能正常时不影响甲状腺功能。
RFA可使主要为实性的甲状腺结节体积大幅缩小，并改善压迫症状和美观问题。RFA不影响正常甲状腺功能，且具有可接受的安全性。
