Argalia G, Migliorini D, Salvolini L, Macellari L, Giuseppetti G M, Morosini P P, Arnaldi G, Vecchi A, Gusella P
Istituto di Semeiologia, Diagnostica e Terapia Strumentale, Università degli Studi di Ancona.
Radiol Med. 1993 Apr;85(4):462-6.
The authors investigated the value of percutaneous ethanol injection in the treatment of Plummer's adenoma. Ten patients were studied: they exhibited a single, hot and toxic nodule in the thyroid. Thyroid autoimmunization (TSAb; TMAb; TGAb) and function (T3; T4; TSH; FT3; FT4) were studied in all patients, before treatment and at 1 month and 3 months. Scintigraphy with 99Tc was performed at the same time intervals. In the euthyroid stage, alcoholization was preceded by US and cytology. Three-four ml of ethanol 95 degrees were injected once or twice a week, from a minimum of 3 to a maximum of 8 injections. Treatment was successful in 2 cases; partial success was obtained in 4 cases, and in 4 cases treatment failed. In all successful cases antibodies were negative and the nodules had hypoechoic echostructure, with a peripheral hypoechoic halo and no areas of internal colliquation. Thus, US-guided percutaneous alcoholization seems to be capable of correct indications in hypoechoic nodules not exhibiting areas of colliquative necrosis and with negative antibodies. However, the problem of the dose of alcohol to inject to treat the nodule thoroughly is still to be debated.
作者研究了经皮乙醇注射治疗普卢默腺瘤的价值。对10例患者进行了研究：他们的甲状腺均有单个、热且有毒性的结节。在所有患者治疗前、治疗后1个月和3个月时，研究了甲状腺自身免疫（TSAb；TMAb；TGAb）和功能（T3；T4；TSH；FT3；FT4）。同时在相同时间间隔进行99Tc闪烁扫描。在甲状腺功能正常阶段，乙醇注射前先进行超声检查和细胞学检查。每周注射1次或2次95度乙醇3 - 4毫升，最少注射3次，最多注射8次。2例治疗成功；4例部分成功，4例治疗失败。在所有成功的病例中，抗体均为阴性，结节具有低回声结构，周边有低回声晕，且无内部液化区域。因此，超声引导下经皮乙醇注射似乎能够对无液化坏死区域且抗体阴性的低回声结节做出正确诊断。然而，彻底治疗结节所需乙醇剂量的问题仍有待探讨。
