Papini E, Panunzi C, Petrucci L, Rinaldi R, Tramutoli R, Pisicchio G, Nardi F
Sezione di Endocrinologia e Malattie del Metabolismo, Ospedale Regina Apostolorum, Albano Laziale, Roma.
Minerva Endocrinol. 1993 Dec;18(4):173-9.
Ultrasound-guided percutaneous ethanol injection (PEI) was performed as a therapeutic procedure on twenty-four patients affected by toxic autonomously functioning thyroid nodules (AFTN). After treatment patients were followed up for a mean period of 12 months. PEI induced persistent and complete (clinical and hormonal) disease control in 19/23 cases (82.6%) that completed the procedure, normalization of serum FT4 and FT3 associated with a still suppressed TSH in 2/23 cases (8.6%) and failed to control hyperthyroidism in 2/23 cases (8.6%). After PEI all AFTN became smaller at clinical and US examination with a 60% mean volume decrease. Nodule shrinkage was related to cytological and histological findings of well circumscribed coagulative necrosis, granulomatous inflammation and progressive fibrosis. PEI induced two cases of temporary complications: 1 case of acute worsening of thyrotoxicosis and 1 case of self-resolving vocal cord paresis. No increase of serum autoantibodies (TgAb, TPOAb, TRAb) was detected during the follow-up period.
对24例患有毒性自主功能性甲状腺结节（AFTN）的患者进行了超声引导下经皮乙醇注射（PEI）治疗。治疗后对患者进行了平均12个月的随访。在完成该治疗的23例患者中，PEI使19例（82.6%）患者实现了持续且完全（临床和激素方面）的疾病控制；23例中有2例（8.6%）患者血清FT4和FT3恢复正常，促甲状腺激素（TSH）仍受抑制；23例中有2例（8.6%）未能控制甲亢。PEI治疗后，所有AFTN在临床和超声检查中均变小，平均体积减少60%。结节缩小与边界清晰的凝固性坏死、肉芽肿性炎症和进行性纤维化的细胞学及组织学表现相关。PEI引发了2例暂时性并发症：1例甲状腺毒症急性加重，1例声带麻痹自行缓解。随访期间未检测到血清自身抗体（TgAb、TPOAb、TRAb）升高。
