Ozdemir H, Ilgit E T, Yücel C, Atilla S, Isik S, Cakir N, Gökçora N
Department of Radiology, School of Medicine, Gazi University, Ankara, Turkey.
AJR Am J Roentgenol. 1994 Oct;163(4):929-32. doi: 10.2214/ajr.163.4.8092038.
We evaluated the efficacy of sonographically guided percutaneous injection of ethanol as an alternative to surgery and administration of radioiodine, which have a higher risk of complications, for treatment of autonomously functioning thyroid nodules that may develop hyperthyroidism.
Sixteen patients between 23 and 67 years of age who had solitary autonomous thyroid nodules were included in the study. The nodules were detected and evaluated using physical examination, measurements of hormonal levels, sonography, and scintigraphy. Sonographically guided percutaneous injection of ethanol was repeated one to two times each week for a total of four to eight treatments. The amount of ethanol used was 0.5-9.0 ml per treatment, depending on the volume of the nodule.
Patients were followed up for at least 18 months. Clinical evaluation, including laboratory tests, showed that the patients' signs and symptoms subsided and hormones returned to normal levels in all cases. Scintigrams showed that the normal thyroid tissue that was suppressed before treatment regained normal function. Sonograms showed that the volume of the nodules decreased in 13 of 16 cases. No early or late permanent complications associated with treatment were noted.
Our results show that sonographically guided percutaneous injection of ethanol can be used as an alternative treatment of autonomous thyroid nodules with the aim of eliminating the possible risk factors of surgery and radioiodine. This method of treatment may be particularly desirable in patients who are poor candidates for surgery and who refuse standard treatment.
对于可能发展为甲状腺功能亢进的自主功能性甲状腺结节，我们评估了超声引导下经皮注射乙醇作为手术和放射性碘治疗替代方法的疗效，后两者具有较高的并发症风险。
16例年龄在23至67岁之间、患有孤立性自主甲状腺结节的患者纳入本研究。通过体格检查、激素水平测定、超声检查和闪烁扫描对结节进行检测和评估。超声引导下经皮注射乙醇每周重复1至2次，总共进行4至8次治疗。每次治疗使用的乙醇量为0.5 - 9.0毫升，具体取决于结节的体积。
患者随访至少18个月。包括实验室检查在内的临床评估显示，所有病例中患者的体征和症状均消退，激素恢复至正常水平。闪烁扫描显示，治疗前受抑制的正常甲状腺组织恢复了正常功能。超声检查显示，16例中有13例结节体积减小。未观察到与治疗相关的早期或晚期永久性并发症。
我们的结果表明，超声引导下经皮注射乙醇可作为自主甲状腺结节的替代治疗方法，以消除手术和放射性碘可能存在的风险因素。对于手术不佳或拒绝标准治疗的患者，这种治疗方法可能特别适用。
