Lin An-Ni, Lin Wei-Che, Cheng Kai-Lun, Luo Sheng-Dean, Chiang Pi-Ling, Chen Wei-Chih, Chen Yueh-Sheng, Wang Cheng-Kang, Kan Na-Ning, Su Yan-Ye
Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan.
Front Pediatr. 2021 Nov 26;9:753343. doi: 10.3389/fped.2021.753343. eCollection 2021.
To evaluate the effectiveness of radiofrequency ablation (RFA) for benign thyroid nodules in pediatric patients. Twelve pediatric patients (11 female, 1 male; mean age 15.54 ± 2.8 years, range 10-19 years) with benign thyroid nodules (mean longest diameter 4.1 ± 1.4 cm, range 1.5-5.9 cm) treated by RFA from 2017 to 2020 were evaluated. The inclusion criteria for RFA therapy were (i) age < 20 years; (ii) benign cytological confirmation by 2 separate ultrasound guided fine-needle aspiration cytology (FNAC) or core needle biopsies; (iii) pressure symptoms or cosmetic problems caused by thyroid nodules; (iv) absence of any sonographic suspicious feature; and (v) follow-up for >6 months. Under local anesthesia, RFA was performed with the use of an RF generator and an 18-gauge internally cooled electrode. Volume changes in nodules on follow-up ultrasonography (US), changes in symptomatic and cosmetic scores, and complications arising during or after RFA were evaluated. Mean follow-up period was 24.9 ± 13.9 months (range 6-43 months). At the last follow-up visits, volume of the nodule had decreased significantly (15.34 ± 11.52 mL vs. 4.07 ± 4.99 mL; < 0.05), whereas volume reduction rate was 74.31% ± 19.59%. Both cosmetic and compressive symptoms were also significantly improved (2.91 ± 0.79 vs. 0.92 ± 0.67 and 1.5 ± 1.93 vs. 0.17 ± 0.39; < 0.05). The mean number of ablation sessions was 1.4 ± 0.6 (range 1-3 sessions), and one of the patients suffered from transient vocal cord palsy which was spontaneously resolved 53 days later. RFA is a safe and effective treatment for benign thyroid nodules in pediatric patients, and can thus serve as an alternative treatment for thyroidectomy.
评估射频消融(RFA)治疗小儿良性甲状腺结节的有效性。对2017年至2020年期间接受RFA治疗的12例小儿良性甲状腺结节患者(11例女性,1例男性;平均年龄15.54±2.8岁,范围10 - 19岁)进行了评估。纳入RFA治疗的标准为:(i)年龄<20岁;(ii)通过2次独立的超声引导下细针穿刺活检(FNAC)或粗针活检获得良性细胞学确诊;(iii)甲状腺结节引起的压迫症状或美容问题;(iv)无任何超声可疑特征;(v)随访>6个月。在局部麻醉下,使用射频发生器和18号内部冷却电极进行RFA。评估随访超声检查(US)时结节的体积变化、症状和美容评分的变化以及RFA期间或之后出现的并发症。平均随访期为24.9±13.9个月(范围6 - 43个月)。在最后一次随访时,结节体积显著减小(15.34±11.52 mL对4.07±4.99 mL;<0.05),而体积缩小率为74.31%±19.59%。美容和压迫症状也均有显著改善(2.91±0.79对0.92±0.67以及1.5±1.93对0.17±0.39;<0.05)。平均消融次数为1.4±0.6(范围1 - 3次),其中1例患者出现短暂性声带麻痹,53天后自行缓解。RFA是治疗小儿良性甲状腺结节的一种安全有效的方法,因此可作为甲状腺切除术的替代治疗方法。