Zhang Yun, Feng Jun, Fu Gang
Department of Ultrasonography, Jiangnan University Medical Center (Wuxi Second People's Hospital), Jiangsu, China.
Medicine (Baltimore). 2024 Dec 6;103(49):e40774. doi: 10.1097/MD.0000000000040774.
This study evaluates the clinical efficacy of microwave ablation in patients with benign thyroid nodules based on contrast-enhanced ultrasound. A total of 92 patients with benign thyroid nodules admitted to our hospital from January 2020 to December 2022 were selected as research subjects and divided into control group and observation group according to different treatment methods, with 46 cases in each group. All patients received microwave ablation. Imaging examination and monitoring were performed before and after microwave ablation. The control group underwent routine ultrasound examination, and the observation group underwent contrast-enhanced ultrasound examination. It was determined whether or not to terminate ablation therapy according to the imaging examination results. Results of enhanced MRI were used as the gold standard to evaluate the clinical efficacy, thyroid nodule volume, thyroid nodule volume reduction rate, nodule recurrence, and complication rate of the 2 groups. Using the results of enhanced MRI as the gold standard, the total ablation rate of observation group was 96.55%, which was significantly higher than that of control group 85.96%, and the nodule survival rate of 3.45% was significantly lower than that of control group 14.04% (P < .05). After 1 month, 3 months, 6 months, and 12 months, the thyroid nodule volume of both groups was significantly reduced, and the thyroid nodule volume of observation group was significantly smaller than that of control group (P < .05). After 1 month, 3 months, 6 months, and 12 months, the reduction rate of thyroid nodule volume in 2 groups was significantly increased, and the reduction rate of thyroid nodule volume in observation group was significantly higher than that in control group (P < .05). After treatment, the recurrence rate of nodule in observation group was 4.35%, which was significantly lower than that in control group, 15.22% (P < .05). After treatment, the complication rate of observation group was 8.70%, which was significantly lower than that of control group 26.09% (P < .05). Contrast-enhanced ultrasound can effectively monitor the treatment range of benign thyroid nodules by microwave ablation, improve clinical efficacy, reduce the recurrence rate of nodules, and has high effectiveness and safety.
本研究基于超声造影评估微波消融治疗良性甲状腺结节患者的临床疗效。选取2020年1月至2022年12月我院收治的92例良性甲状腺结节患者作为研究对象，根据治疗方法不同分为对照组和观察组，每组46例。所有患者均接受微波消融治疗。在微波消融前后进行影像学检查及监测。对照组行常规超声检查，观察组行超声造影检查。根据影像学检查结果决定是否终止消融治疗。以增强MRI结果作为金标准，评估两组的临床疗效、甲状腺结节体积、甲状腺结节体积缩小率、结节复发情况及并发症发生率。以增强MRI结果为金标准，观察组的总消融率为96.55%，显著高于对照组的85.96%，结节残留率3.45%显著低于对照组的14.04%（P<0.05）。1个月、3个月、6个月及12个月后，两组甲状腺结节体积均显著缩小，且观察组甲状腺结节体积显著小于对照组（P<0.05）。1个月、3个月、6个月及12个月后，两组甲状腺结节体积缩小率均显著升高，且观察组甲状腺结节体积缩小率显著高于对照组（P<0.05）。治疗后，观察组结节复发率为4.35%，显著低于对照组的15.22%（P<0.05）。治疗后，观察组并发症发生率为8.70%，显著低于对照组的26.09%（P<0.05）。超声造影可有效监测微波消融治疗良性甲状腺结节的范围，提高临床疗效，降低结节复发率，具有较高的有效性及安全性。
