Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Clin Hemorheol Microcirc. 2023;84(3):263-273. doi: 10.3233/CH-231699.
Our research sought to investigate the relationship between initial ablation ratio (IAR) and internal composition of benign thyroid nodules treated by microwave ablation (MWA).
Patients who underwent MWA at the Affiliated Hospital of Jiangsu University from January 2018 to December 2022 were enrolled in our research. All the patients were followed up for at least one year. We analyzed the relationship between IAR at 1 month of solid nodules (solid >90%), predominantly solid nodules (90% >solid > 75%), mixed solid alongside cystic nodules (75% >solid > 50%) as well as volume reduction rate (VRR) at 1, 3, 6 and 12 months follow-up.
The mean IAR of the solid nodules (solid >90%) was 94.32±7.87%,#x0025;, that of the predominantly solid nodules (90% >solid > 75%) and mixed solid alongside cystic nodules (75% >solid > 50%) were 86.51±6.66% and 75.19±4.97%,#x0025;, respectively. Almost all the thyroid nodules were significantly decreased in size after MWA. After 12 months of MWA treatment, the average volume of the aforementioned thyroid nodules decreased from 8.69±8.79 to 1.84±3.11 ml, 10.94±9.07 to 2.58±3.34 ml, 9.92±6.27 to 0.25±0.42 ml, respectively. The mean symptom and cosmetic scores of the nodules showed significant (p < 0.000) improvement. The rates of the complications or side effects of MWA against the above-mentioned nodule types were 8.3% (3/36), 3.2% (1/31) and 0% (0/36), respectively.
The application of the IAR to quantify the success rate of thyroid nodule microwaves in the short term demonstrated that IAR was related to the internal components of the nodule. Although the IAR was not high when the thyroid component was mixed solid and cystic nodules (75% >solid > 50%), the final therapeutic effect was still satisfactory.
本研究旨在探讨微波消融（MWA）治疗良性甲状腺结节时初始消融率（IAR）与结节内部成分的关系。
选取 2018 年 1 月至 2022 年 12 月在江苏大学附属医院行 MWA 治疗的患者纳入本研究，所有患者均至少随访 1 年。分析 1 个月时实性结节（实性>90%）、以实性为主的结节（90%>实性>75%）、混合性实性伴囊性结节（75%>实性>50%）的 IAR 以及 1、3、6、12 个月时体积缩小率（VRR）与疗效的关系。
实性结节（实性>90%）的平均 IAR 为 94.32±7.87%，以实性为主的结节（90%>实性>75%）和混合性实性伴囊性结节（75%>实性>50%）的 IAR 分别为 86.51±6.66%和 75.19±4.97%。MWA 后几乎所有甲状腺结节均显著缩小，治疗 12 个月后，上述甲状腺结节平均体积分别由 8.69±8.79 ml 降至 1.84±3.11 ml、10.94±9.07 ml 降至 2.58±3.34 ml、9.92±6.27 ml 降至 0.25±0.42 ml。结节症状和美容评分均显著改善（p<0.000）。上述结节类型 MWA 相关并发症或不良反应发生率分别为 8.3%（3/36）、3.2%（1/31）和 0%（0/36）。
应用 IAR 量化甲状腺结节微波消融的短期成功率显示，IAR 与结节内部成分有关，尽管当甲状腺成分是混合性实性和囊性结节（75%>实性>50%）时 IAR 不高，但最终治疗效果仍令人满意。
