Wei Ying, Zhao Zhen-Long, Niu Yun, Peng Li-Li, Li Yan, Yu Ming-An
Department of Interventional Medicine, China-Japan Friendship Hospital, No. 2 Ying-hua-yuan East Street, Chao-yang district, Beijing, 100029, China.
Department of Pathology, China-Japan Friendship Hospital, Beijing, China.
Sci Rep. 2025 Feb 6;15(1):4503. doi: 10.1038/s41598-025-88306-8.
This study aims to examine the ultrasonic characteristics of perithyroid fascial spaces following in vivo hydrodissection, validating their visualization through a comparative analysis with anatomical references. A retrospective review was conducted on data from 2390 patients (631 males and 1759 females, median age 46 years, 25-75% interquartile range 26-69 years) who underwent microwave ablation for thyroid tumors, including 1436 benign nodules and 954 papillary thyroid carcinomas. Detailed descriptions of perithyroid fascial spaces and the hydrodissection strategy were provided. Ultrasonic characteristics of fascial spaces during hydrodissection were documented and systematically compared with anatomical references. Hydrodissection was successfully performed in all cases according to the protocol. Isolating fluid was injected into classic anatomical spaces: anterior cervical (58.5%), pretracheal (71.8%, including Berry's ligament in 196 cases), retropharyngeal (43.7%), and carotid (1.2%). Additionally, US revealed two new spaces-perilymphatic (4.1%) and tracheoesophageal groove (3.7%)-with corresponding anatomical structures. The US-identified fascial structures aligned with their anatomical positions and distribution. US-guided hydrodissection facilitates the visualization of the fascial space, making it possible to study the microenvironment physiology and pathology of fascia in vivo.
本研究旨在探讨体内水分离术后甲状腺周围筋膜间隙的超声特征，并通过与解剖学参考进行对比分析来验证其可视化情况。对2390例接受甲状腺肿瘤微波消融术的患者（631例男性和1759例女性，中位年龄46岁，四分位数间距25 - 75%为26 - 69岁）的数据进行了回顾性分析，其中包括1436个良性结节和954例甲状腺乳头状癌。提供了甲状腺周围筋膜间隙和水分离策略的详细描述。记录了水分离过程中筋膜间隙的超声特征，并与解剖学参考进行了系统比较。所有病例均按照方案成功进行了水分离。隔离液被注入经典解剖间隙：颈前间隙（58.5%）、气管前间隙（71.8%，其中196例包括Berry韧带）、咽后间隙（43.7%）和颈动脉间隙（1.2%）。此外，超声还显示了两个新的间隙——淋巴管周围间隙（4.1%）和气管食管沟间隙（3.7%）——及其相应的解剖结构。超声识别的筋膜结构与其解剖位置和分布一致。超声引导下的水分离有助于筋膜间隙的可视化，从而有可能在体内研究筋膜的微环境生理和病理情况。
