Cho Woojin, Sim Jung Suk, Jung So Lyung
Department of Otolaryngology-Head and Neck Surgery, Withsim Clinic, Seongnam, Korea.
Department of Radiology, Withsim Clinic, Seongnam, Korea.
Ultrasonography. 2021 Jul;40(3):417-427. doi: 10.14366/usg.20170. Epub 2020 Dec 22.
The aim of this study was to evaluate the efficacy of ethanol ablation (EA) in the treatment of cystic thyroid nodules using low-dose ethanol regardless of the initial volume of the nodule or properties of the aspirate.
Sixty-one nodules in 60 patients were treated with EA from October 2013 to January 2020. In each patient, EA was performed only once, using less than 5 mL of ethanol (99.5%) instilled and removed completely after a few minutes of retention. Nodule volume, the symptom score, the cosmetic score, and complications were evaluated before and after treatment. The therapeutic success rate (TSR) and volume reduction rate (VRR) according to nodule volume and properties of the aspirate were evaluated. Therapeutic success was defined as the absence of any residual fluid or sufficient volume reduction (≥50%) with improvement of nodule-related symptoms.
The 61 nodules comprised 38 pure cysts and 23 predominantly cystic nodules. The initial nodule volume was 21.9±15.2 mL (range, 4.4 to 77.2 mL). The TSR was 88.5% (100% in pure cysts and 69.6% in predominantly cystic nodules, P<0.001). The TSR of pure cysts was 100% regardless of nodule volume and properties of the aspirate. In predominantly cystic nodules, the TSR and VRR gradually decreased as volume increased. One patient experienced arrhythmia during the procedure, but completely recovered without sequelae.
Single-session EA using low-dose ethanol might be effective for the treatment of symptomatic cystic thyroid nodules regardless of the initial cyst volume and properties of the aspirate, especially in pure cysts.
本研究旨在评估低剂量乙醇消融术（EA）治疗甲状腺囊性结节的疗效，无论结节的初始体积或抽吸物的性质如何。
2013年10月至2020年1月，对60例患者的61个结节进行了EA治疗。每位患者仅进行一次EA，使用少于5 mL的乙醇（99.5%），注入后保留几分钟，然后完全抽出。在治疗前后评估结节体积、症状评分、美容评分和并发症。根据结节体积和抽吸物性质评估治疗成功率（TSR）和体积缩小率（VRR）。治疗成功定义为无任何残留液体或体积充分缩小（≥50%）且结节相关症状改善。
61个结节包括38个单纯囊肿和23个以囊性为主的结节。初始结节体积为21.9±15.2 mL（范围4.4至77.2 mL）。TSR为88.5%（单纯囊肿为100%，以囊性为主的结节为69.6%，P<0.001）。单纯囊肿的TSR为100%，与结节体积和抽吸物性质无关。在以囊性为主的结节中，TSR和VRR随体积增加而逐渐降低。1例患者在手术过程中出现心律失常，但完全康复，无后遗症。
无论初始囊肿体积和抽吸物性质如何，尤其是在单纯囊肿中，低剂量乙醇单次EA治疗有症状的甲状腺囊性结节可能有效。
