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超声引导下射频消融治疗原发性甲状腺微小乳头状癌的临床疗效。

Clinical outcomes of ultrasound-guided radiofrequency ablation for the treatment of primary papillary thyroid microcarcinoma.

机构信息

Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China.

Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China.

出版信息

Clin Radiol. 2019 Sep;74(9):712-717. doi: 10.1016/j.crad.2019.05.012. Epub 2019 Jun 26.

Abstract

AIM

To evaluate the safety, efficacy, and long-term outcomes of ultrasound-guided radiofrequency ablation (RFA) for the treatment of primary papillary thyroid microcarcinoma (PTMC).

MATERIALS AND METHODS

A total of 37 patients with 38 PTMC nodules underwent RFA at a power of 20 W between September 2014 and December 2017. The clinical data of these patients were reviewed retrospectively and analysed. Imaging studies of the nodules were conducted, and the patients' thyroid function was assessed before RFA; 1, 3, 6, and 12 months after RFA; and every 6 months thereafter. The volumes and volume reduction rate (VRR) of the nodules were also calculated.

RESULTS

RFA with a low power of 20 W was used in the treatment of 37 patients with 38 PTMC nodules. All nodules achieved complete ablation, no complications occurred, and thyroid function was not affected. During follow-up, the volume of the nodules gradually decreased. Twelve months after ablation, the mean volumes of the nodules significantly decreased to 0.01±0.03 ml with a VRR of 99.34±3.49%. At a median follow-up of 6 (range: 1-18) months, 37 of the 38 nodules were completely absorbed, and no recurrence was observed in all 37 patients.

CONCLUSIONS

Low-power RFA showed good safety and promising efficacy outcomes for the treatment of PTMC. In addition to surgery and active surveillance, RFA may be an alternative treatment option for patients with PTMC.

摘要

目的

评估超声引导下射频消融(RFA)治疗原发性甲状腺微小乳头状癌(PTMC)的安全性、疗效和长期结果。

材料与方法

回顾性分析 2014 年 9 月至 2017 年 12 月期间,共 37 例 38 个 PTMC 结节患者接受 20 W 功率 RFA 的临床资料。对患者进行影像学检查,评估甲状腺功能,在 RFA 前、1、3、6 和 12 个月以及此后每 6 个月进行评估。计算结节的体积和体积减少率(VRR)。

结果

采用 20 W 低功率 RFA 治疗 37 例 38 个 PTMC 结节。所有结节均达到完全消融,无并发症发生,甲状腺功能不受影响。随访期间,结节体积逐渐缩小。消融后 12 个月,结节平均体积显著减小至 0.01±0.03 ml,VRR 为 99.34±3.49%。中位随访 6(范围:1-18)个月时,38 个结节中有 37 个完全吸收,37 例患者均未见复发。

结论

低功率 RFA 治疗 PTMC 安全且疗效良好。除手术和主动监测外,RFA 可能是治疗 PTMC 患者的另一种选择。

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