Radiofrequency Ablation of Thyroid Nodules: A Long-Term Prospective Study of 24 Patients
Radiofrequency Ablation of Thyroid Nodules: A Long-Term Prospective Study of 24 Patients
复制标题
DOI：
10.1016/j.jvir.2019.04.022
复制
发表时间：
2019-10-01
影响因子：
2.9
通讯作者：
Ruiz Perez, Enrique
中科院分区：
文献类型：
--
作者：
Aldea Martinez, Jesus;Aldea Viana, Laura;Ruiz Perez, Enrique
目的：目的：评价甲状腺实性结节和混合性结节射频消融治疗后较长时间内的体积缩小率（VRR），确定消融参数，评价射频消融的并发症、成功率和安全性。材料与方法：在这项前瞻性研究中，24例甲状腺实性结节和混合性结节患者接受了射频消融治疗。（83%女性和17%男性;年龄50.17 ± 13.6岁）接受了超声引导下经皮射频消融良性甲状腺结节，并在治疗后1、3、6、12、24和36个月进行了放射学随访。所有患者均出现压迫或美容投诉，超声检查甲状腺成像报告和数据系统显示1或2个结节，并在2次细针抽吸后确认为Bethesda II类。结果：本研究共纳入24个结节（54.2%为实性，37.5%以实性为主，8.3%以囊性为主）。在24个月和36个月时发现VRR（%）的显著结果分别为69.92 +/- 19.23和76.84 +/- 15.92。此外，对数关系时，发现VRR随时间的推移，在固体和混合结节。未发现与任何消融参数相关。12个月时成功率达到72.22%，总并发症发生率为16.67%（12.5%的轻微并发症和4.2%的严重并发症-1喉神经麻痹），达到83.3%的安全性。结论：射频消融可以是一种替代治疗方式在良性症状性甲状腺结节的管理。结果表明，正确采用经峡部入路和移动弹丸技术是一种安全有效的治疗方法。
Purpose: To evaluate the volume reduction rate (VRR) of thyroid nodules over a long period of time after radiofrequency (RF) ablation treatment in both solid and mixed nodules; to determine ablation parameters; and to evaluate complications and success rates and safety of RF ablation.Material and Methods: In this prospective study, 24 patients (83% females and 17% males; age 50.17 +/- 13.6 years) underwent ultrasound-guided percutaneous RF ablation of benign thyroid nodules with radiologic follow-up at 1, 3, 6, 12, 24, and 36 months after treatment. All patients presented with compressive or cosmetic complaints and with Thyroid Imaging Reporting and Data System 1 or 2 nodules under ultrasound and were confirmed to be Bethesda Category II after 2 fine-needle aspirations.Results: A total of 24 nodules (54.2% solid, 37.5% solid predominance, and 8.3% cystic predominance) were included in this study. Significant results in VRR (%) were found at 24 months and 36 months of 69.92 +/- 19.23 and 76.84 +/- 15.92, respectively. Furthermore, a logarithmic relationship was found when VRR was plotted over time, in both solid and mixed nodules. No correlations were found with any of the ablation parameters. The success rate reached 72.22% at 12 months, and the total complication rate was 16.67% (12.5% minor complications and 4.2% major complications-1 laryngeal nerve palsy), reaching an 83.3% safety.Conclusions: RF ablation can be an alternative treatment modality in the management of benign symptomatic thyroid nodules. The results show that it is a safe and effective treatment if trans-isthmic approach and moving-shot techniques are correctly followed.