Hu Cai, Liu Huahui, Zhang Yi, Xu Shuxian, Liang Shuang, Yang Jing, Liu Qiqi, Xu Erjiao
Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Ultrasound Med Biol. 2025 Aug;51(8):1189-1194. doi: 10.1016/j.ultrasmedbio.2025.04.001. Epub 2025 May 1.
This study aimed to analyze the risk factors that cause hoarseness after microwave ablation (MWA) and establish a visual zoning approach combined with a nomogram to predict the risk of hoarseness after MWA.
Retrospective analysis of the images and clinical data of patients with thyroid nodules who underwent MWA was carried out from January 2021 to September 2024. Patients were divided into benign thyroid nodule and papillary thyroid cancer (PTC) groups. Parameters related to hoarseness were analyzed, including age, sex, multifocality, glandular thickness, nodule components, ablation power, nodule location, maximum nodule diameter and nodule distance from the thyroid capsule and tracheoesophageal groove, as well as a new "three-zone method." Three different prediction models and a nomogram were constructed to predict the risk of hoarseness.
A total of 446 patients (126 males and 320 females; median age 44 years) with a total of 542 nodules were included in this study. The overall incidence rate of hoarseness after MWA was 2.9% (13/446), while it was 2.2% (5/223) in the benign nodule group and 3.6% (8/223) in the PTC group. Multivariate analysis showed that away from anterior capsule distance, close to tracheoesophageal groove distance and location in zone 3 were risk factors of hoarseness after MWA for PTC nodules. The above variables and outcomes were visualized via nomogram (C-index = 0.910).
This combined model with the "three-zone method" and established nomogram could be employed to predict the incidence of hoarseness after MWA for PTC.
本研究旨在分析微波消融（MWA）后导致声音嘶哑的危险因素，并建立一种结合可视化分区方法和列线图来预测MWA后声音嘶哑风险的方法。
对2021年1月至2024年9月接受MWA的甲状腺结节患者的图像和临床资料进行回顾性分析。患者分为良性甲状腺结节组和甲状腺乳头状癌（PTC）组。分析与声音嘶哑相关的参数，包括年龄、性别、多灶性、腺体厚度、结节成分、消融功率、结节位置、最大结节直径以及结节与甲状腺包膜和气管食管沟的距离，以及一种新的“三区法”。构建三种不同的预测模型和一个列线图来预测声音嘶哑的风险。
本研究共纳入446例患者（男126例，女320例；中位年龄44岁），共542个结节。MWA后声音嘶哑的总体发生率为2.9%（13/446），良性结节组为2.2%（5/223），PTC组为3.6%（8/223）。多因素分析显示，远离前包膜距离、靠近气管食管沟距离以及位于3区是PTC结节MWA后声音嘶哑的危险因素。通过列线图将上述变量和结果进行可视化（C指数=0.910）。
这种结合“三区法”的模型和建立的列线图可用于预测PTC患者MWA后声音嘶哑的发生率。
