不同成分良性甲状腺结节超声引导下微波消融术后体积缩小率与时间的关系。
The association between volume reduction ratio and time after ultrasound-guided microwave ablation for benign thyroid nodules of different compositions.
作者信息
Jin Chunchun, Liu Weizong, Zhang Jing, Chen Yihao, Xu Lifeng, Lu Jianghao, Zheng Jing, Sun Xiangmei, Li Zhengyi
机构信息
Department of Ultrasound, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Department of Ultrasound, Huizhou Central People's Hospital, Huizhou, China.
出版信息
Quant Imaging Med Surg. 2025 May 1;15(5):4343-4351. doi: 10.21037/qims-24-2096. Epub 2025 Apr 25.
BACKGROUND
Ultrasound-guided microwave ablation (MWA) is effective in the treatment of benign thyroid nodules (BTNs); however, there are large individual differences in the degree of lesion absorption and shrinkage speed. Although the internal components of nodules are important influential factors, few studies have reported temporal changes in the volume reduction ratio (VRR) in BTNs with different compositions. Therefore, this study aimed to explore how the thyroid nodule VRR changes over time and determine when it increases most significantly for BTNs of different compositions after MWA.
METHODS
This is a retrospective study. We consecutively collected patients that received MWA for BTNs from July 2020 to June 2021, with 12 months of follow-up, and VRR >50% as effective treatment indicator. A generalized additive model was used to analyze temporal changes in the VRR in BTNs of different compositions, and a log-likelihood ratio test of the segmented regression model was used to determine a potential threshold. We evaluated the consistency of two operators in MWA of BTNs.
RESULTS
In total, 221 treatment-effective nodules (216 patients) were included, in which 21 were predominantly cystic, 61 were predominantly solid, and 139 were solid nodules. A non-linear relationship was detected between VRR and time. In predominantly cystic nodules, the VRR increased by 36% per month until 2.0 months and by 1.4% per month after 2.0 months. In predominantly solid nodules, the VRR increased by 30.6% per month until 2.3 months and by 0.7% per month after 2.3 months. In solid nodules, the VRR increased by 17.4% per month until 4.3 months and by 0.3% per month after 4.3 months. Intraclass correlation coefficient (ICC) was 0.839 (95% confidence interval: 0.773, 0.887), indicating good consistency between the two operators.
CONCLUSIONS
The VRR after ultrasound-guided MWA for different components of BTNs was non-linearly related with follow-up time, and there was a threshold effect.
背景
超声引导下微波消融（MWA）治疗良性甲状腺结节（BTN）有效；然而，病灶吸收程度和缩小速度存在较大个体差异。尽管结节内部成分是重要影响因素，但很少有研究报道不同成分BTN的体积缩小率（VRR）随时间的变化。因此，本研究旨在探讨甲状腺结节VRR如何随时间变化，并确定MWA后不同成分BTN的VRR何时增加最为显著。
方法
这是一项回顾性研究。我们连续收集了2020年7月至2021年6月接受MWA治疗BTN的患者，随访12个月，以VRR>50%作为有效治疗指标。采用广义相加模型分析不同成分BTN的VRR随时间的变化，并采用分段回归模型的对数似然比检验确定潜在阈值。我们评估了两名操作者在BTN的MWA操作中的一致性。
结果
共纳入221个治疗有效的结节（216例患者），其中21个以囊性为主，61个以实性为主，139个为实性结节。VRR与时间之间存在非线性关系。在以囊性为主的结节中，VRR在2.0个月前每月增加36%，在2.0个月后每月增加1.4%。在以实性为主的结节中，VRR在2.3个月前每月增加30.6%，在2.3个月后每月增加0.7%。在实性结节中，VRR在4.3个月前每月增加17.4%，在4.3个月后每月增加0.3%。组内相关系数（ICC）为0.839（95%置信区间：0.773，0.887），表明两名操作者之间具有良好的一致性。
结论
超声引导下MWA治疗不同成分BTN后的VRR与随访时间呈非线性相关，存在阈值效应。
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