Medical School of Chinese PLA, Beijing, China.
Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
Int J Hyperthermia. 2020;37(1):168-174. doi: 10.1080/02656736.2019.1708480.
To evaluate the safety and efficacy of ultrasound-guided RFA for the treatment of papillary thyroid microcarcinoma (PTMC). The data of 204 nodules from 198 PTMC patients who were treated using RFA were retrospectively reviewed in this study. Demographic variables, complication details and CEUS results in different time points were collected. The volumes and volume reduction rate (VRR) of the ablated area under CEUS at different follow-up time points were calculated and compared. All the patients were successfully treated without major complication. Mild complications included cervical discomfort in three cases, postoperative cervical pain in one case, and transient hoarse voice in five cases. The volume of the ablated area in the 1st, 3rd, 6th, 12th, 18th and 24th month postoperatively were 241.7 ± 298.3mm, 89.8 ± 147.2 mm, 37.6 ± 87.2 mm, 13.6 ± 59.8 mm, 2.4 ± 14.4 mm, and 0.2 ± 2.0 mm respectively, with a statistically significant decrease ( = 138.1, = .000), and the VRR in those time points were 73.9 ± 13.7%, 90.5 ± 8.2%, 96.1 ± 5.9%, 98.8 ± 3.2%, 99.6 ± 1.9% and 99.8 ± 1.0% respectively, with a statistically significant decrease ( = 695.3, = .000). US-guided RFA is safe and effective for PTMC, with a good oncological outcome and VRR. Further randomized controlled prospective trials are still needed to compare the value of RFA and surgery.
评估超声引导射频消融（RFA）治疗甲状腺微小乳头状癌（PTMC）的安全性和有效性。本研究回顾性分析了 198 例接受 RFA 治疗的 204 个甲状腺结节患者的数据。收集了人口统计学变量、并发症详细信息和不同时间点的对比增强超声（CEUS）结果。计算并比较了不同随访时间点 CEUS 下消融区域的体积和体积减少率（VRR）。所有患者均成功治疗，无严重并发症。轻度并发症包括 3 例颈部不适，1 例术后颈部疼痛，5 例暂时性声音嘶哑。术后 1、3、6、12、18 和 24 个月的消融区域体积分别为 241.7 ± 298.3mm、89.8 ± 147.2mm、37.6 ± 87.2mm、13.6 ± 59.8mm、2.4 ± 14.4mm 和 0.2 ± 2.0mm，体积逐渐减小（ = 138.1， = .000），相应的 VRR 分别为 73.9%±13.7%、90.5%±8.2%、96.1%±5.9%、98.8%±3.2%、99.6%±1.9%和 99.8%±1.0%，均呈统计学显著降低（ = 695.3， = .000）。超声引导 RFA 治疗 PTMC 安全有效，具有良好的肿瘤学结果和 VRR。仍需要进一步的随机对照前瞻性试验来比较 RFA 和手术的价值。
