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射频消融甲状腺结节:24 例患者的长期前瞻性研究。

Radiofrequency Ablation of Thyroid Nodules: A Long-Term Prospective Study of 24 Patients.

机构信息

Hospital Universitario de Burgos (HUBU), C. Islas Baleares n3, Burgos, Burgos 09006, Spain.

Hospital Universitario de Burgos (HUBU), C. Islas Baleares n3, Burgos, Burgos 09006, Spain.

出版信息

J Vasc Interv Radiol. 2019 Oct;30(10):1567-1573. doi: 10.1016/j.jvir.2019.04.022. Epub 2019 Jul 30.

Abstract

PURPOSE

To evaluate the volume reduction rate (VRR) of thyroid nodules over a long period of time after radiofrequency (RF) ablation treatment in both solid and mixed nodules; to determine ablation parameters; and to evaluate complications and success rates and safety of RF ablation.

MATERIAL AND METHODS

In this prospective study, 24 patients (83% females and 17% males; age 50.17 ± 13.6 years) underwent ultrasound-guided percutaneous RF ablation of benign thyroid nodules with radiologic follow-up at 1, 3, 6, 12, 24, and 36 months after treatment. All patients presented with compressive or cosmetic complaints and with Thyroid Imaging Reporting and Data System 1 or 2 nodules under ultrasound and were confirmed to be Bethesda Category II after 2 fine-needle aspirations.

RESULTS

A total of 24 nodules (54.2% solid, 37.5% solid predominance, and 8.3% cystic predominance) were included in this study. Significant results in VRR (%) were found at 24 months and 36 months of 69.92 ± 19.23 and 76.84 ± 15.92, respectively. Furthermore, a logarithmic relationship was found when VRR was plotted over time, in both solid and mixed nodules. No correlations were found with any of the ablation parameters. The success rate reached 72.22% at 12 months, and the total complication rate was 16.67% (12.5% minor complications and 4.2% major complications-1 laryngeal nerve palsy), reaching an 83.3% safety.

CONCLUSIONS

RF ablation can be an alternative treatment modality in the management of benign symptomatic thyroid nodules. The results show that it is a safe and effective treatment if trans-isthmic approach and moving-shot techniques are correctly followed.

摘要

目的

评估射频(RF)消融治疗后甲状腺结节在长时间内的体积缩小率(VRR),包括实性和混合性结节;确定消融参数;评估并发症、成功率和安全性。

材料和方法

前瞻性研究纳入 24 例患者(83%为女性,17%为男性;年龄 50.17±13.6 岁),因有压迫或美容方面的诉求,且超声检查发现甲状腺影像报告和数据系统(TI-RADS)1 或 2 类结节,行超声引导下经皮射频消融术治疗,治疗后 1、3、6、12、24 和 36 个月进行影像学随访。所有患者均经 2 次细针抽吸活检证实为贝塞斯达分类Ⅱ类后,诊断为良性甲状腺结节。

结果

本研究共纳入 24 个结节(54.2%为实性,37.5%实性为主,8.3%囊性为主)。24 个月和 36 个月时的 VRR(%)分别为 69.92±19.23 和 76.84±15.92,差异具有统计学意义。此外,在实性和混合性结节中,VRR 随时间呈对数关系。未发现任何消融参数与 VRR 之间存在相关性。12 个月时的成功率为 72.22%,总并发症发生率为 16.67%(12.5%为轻微并发症,4.2%为严重并发症-1 例喉返神经麻痹),安全性为 83.3%。

结论

射频消融术是治疗良性有症状甲状腺结节的一种替代治疗方法。结果表明,如果正确遵循经峡部入路和移动射击技术,该方法是安全有效的。

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