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超声造影在甲状腺良性结节微创消融中的应用

Application of contrast-enhanced ultrasound in minimally invasive ablation of benign thyroid nodules.

作者信息

Cao Jiaying, Fan Peili, Wang Feihang, Shi Shuainan, Liu Lingxiao, Yan Zhiping, Dong Yi, Wang Wenping

机构信息

Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.

Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

J Interv Med. 2022 Feb 26;5(1):32-36. doi: 10.1016/j.jimed.2021.12.008. eCollection 2022 Feb.

Abstract

OBJECTIVE

This study aimed to investigate the application value of contrast-enhanced ultrasound (CEUS) before and after minimally invasive ablation procedures for benign thyroid nodule(s) (BTN).

METHODS

This prospective study included patients with BTNs scheduled to undergo ultrasound-guided minimally invasive ablation treatment. CEUS was performed before and after ablation (at 1 day, and 1, 6, and 12 months after ablation). Changes in microvascular perfusion and the volume of BTNs were noted and assessed.

RESULTS

Sixty-two patients (62 BTNs), who underwent ablation procedures between June 2016 and August 2020, were included. All lesions were confirmed by biopsy, and histopathological results were obtained before ablation treatment. On preoperative CEUS, the lesions exhibited hyperenhancement (53.23%) or iso-enhancement (46.77%) during the arterial phase, and all lesions exhibited iso-enhancement in the venous and late phases. One day after ablation, none of the BTNs exhibited obvious enhancement on CEUS. One (1.61%) lesion was re-treated due to a nodule-like enhancement area detected by CEUS at the 6-month follow-up. The mean nodular volume reduction rate (VRR) at 1, 6, and 12 months follow-up demonstrated no significant difference between the two ablation groups (microwave ablation versus radiofrequency ablation). Twelve months after ablation, the mean (±SD) VRR of all BTNs was 60.3 ​± ​10.3%.

CONCLUSION

CEUS helped guide treatment decisions for BTNs before ablation treatment. Moreover, it could also be used to accurately and noninvasively evaluate treatment efficacy.

摘要

目的

本研究旨在探讨超声造影(CEUS)在良性甲状腺结节(BTN)微创消融术前及术后的应用价值。

方法

本前瞻性研究纳入计划接受超声引导下微创消融治疗的BTN患者。在消融术前及术后(消融后1天、1、6和12个月)进行CEUS检查。记录并评估微血管灌注及BTN体积的变化。

结果

纳入2016年6月至2020年8月期间接受消融手术的62例患者(62个BTN)。所有病变均经活检确诊,并在消融治疗前获得组织病理学结果。术前CEUS检查显示,病变在动脉期呈高增强(53.23%)或等增强(46.77%),所有病变在静脉期和延迟期均呈等增强。消融后1天,所有BTN在CEUS上均未表现出明显增强。6个月随访时,1个(1.61%)病变因CEUS检测到结节样增强区域而接受再次治疗。两个消融组(微波消融与射频消融)在1、6和12个月随访时的平均结节体积缩小率(VRR)无显著差异。消融后12个月,所有BTN的平均(±标准差)VRR为60.3±10.3%。

结论

CEUS有助于指导BTN消融治疗前的治疗决策。此外,它还可用于准确、无创地评估治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/009e/8947980/4a66d7ae01d6/gr1.jpg

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