乙醇消融治疗甲状舌管囊肿：超过2年的随访结果
Ethanol ablation for the treatment of thyroglossal duct cysts: follow-up results for longer than 2 years.
作者信息
Park Sang Ik, Baek Jung Hwan, Chung Sae Rom, Choi Young Jun, Lee Jeong Hyun, Kim Tae Yong, Lee Yu-Mi, Baek Seon Mi
机构信息
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea.
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea.
出版信息
Eur Radiol. 2022 May;32(5):3525-3531. doi: 10.1007/s00330-021-08402-x. Epub 2022 Jan 7.
OBJECTIVES
To evaluate the long-term efficacy and safety of ethanol ablation (EA) for the treatment of thyroglossal duct cysts (TGDCs).
METHODS
This retrospective study included 81 consecutive patients diagnosed with and treated for symptomatic TGDCs at two institutions between Jan 2008 and Oct 2018. Preprocedural evaluation included US assessment with calculation of the TGDC volume. EA was performed under US guidance using 99% ethanol. Post-treatment follow-up was scheduled within 3 months, 6 months, and then annually. Immediate success was defined as a volume reduction ratio (VRR; ratio of the volume difference after EA to the initial TGDC volume) > 50% within 3 months. Long-term success was defined as VRR > 50% or resolution or improvement of cosmetic problems and symptoms without recurrence at last follow-up.
RESULTS
Seventy-seven patients underwent EA, and outcomes were assessed in 68 patients with available follow-up data. The immediate success rate of the first EA was 81% (55/68), with a mean VRR within 3 months of 73% ± 31%. One patient (1.5%, 1/68) developed wound inflammation after the first EA. Forty-two patients were followed up for longer than 2 years. For the median follow-up of 69 months (range, 24-131 months), the long-term success rate was 83% (35/42), with a mean VRR at last follow-up of 81% ± 35%. No patients developed malignancy from the ablated TGDCs.
CONCLUSIONS
EA for treatment of TGDCs achieved acceptable rates of immediate and long-term efficacy with a low complication rate, and can be considered as a first-line treatment for the management of TGDCs.
KEY POINTS
• The immediate success rate of EA for the treatment of TGDCs was 81% (55/68), with a mean VRR within 3 months of 73% ± 31%. • For the median follow-up of 69 months (range, 24-131 months), the long-term success rate was 83% (35/42), with a mean VRR at last follow-up of 81% ± 35%. • No patients developed malignancy from the ablated TGDCs but one patient (1.5%, 1/68) developed wound inflammation after the first EA.
目的
评估乙醇消融术（EA）治疗甲状舌管囊肿（TGDCs）的长期疗效和安全性。
方法
这项回顾性研究纳入了2008年1月至2018年10月期间在两家机构连续诊断并接受治疗的81例有症状的TGDCs患者。术前评估包括超声评估并计算TGDC体积。EA在超声引导下使用99%乙醇进行。治疗后随访安排在3个月、6个月，之后每年进行。即刻成功定义为3个月内体积缩小率（VRR；EA后体积差与初始TGDC体积之比）>50%。长期成功定义为VRR>50%或在最后一次随访时囊肿消失或外观问题及症状改善且无复发。
结果
77例患者接受了EA，对68例有可用随访数据的患者进行了结局评估。首次EA的即刻成功率为81%（55/68），3个月内平均VRR为73%±31%。1例患者（1.5%，1/68）在首次EA后出现伤口炎症。42例患者随访时间超过2年。中位随访时间为69个月（范围24 - 131个月），长期成功率为83%（35/42），最后一次随访时平均VRR为81%±35%。消融的TGDCs未发生恶变。
结论
EA治疗TGDCs取得了可接受的即刻和长期疗效，并发症发生率低，可被视为TGDCs治疗的一线方法。
要点
• EA治疗TGDCs的即刻成功率为81%（55/68），3个月内平均VRR为73%±31%。• 中位随访69个月（范围24 - 131个月），长期成功率为83%（35/42），最后一次随访时平均VRR为81%±35%。• 消融的TGDCs未发生恶变，但1例患者（1.5%，1/68）在首次EA后出现伤口炎症。
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