超声引导下甲状腺良性结节经皮热消融的临床研究

目的探讨超声引导下经皮穿刺热消融治疗甲状腺良性结节的临床效果及安全性。方法对50枚甲状腺良性结节(包括腺瘤和增生),在超声引导下经皮穿刺活检后行射频或微波消融治疗,评价消融区的坏死和萎缩程度,以及消融术相关的副作用及并发症。结果 50枚甲状腺结节消融后经超声造影检测显示全部丧失血供,且消融区范围完全覆盖原结节大小;超声随访检查发现消融区发生不同程度的萎缩,其中完全消失者6枚(12%),结节直径缩小超过1/2者32枚(64%),结节直径缩小低于1/2者12枚(24%)。所有病例均未发生颈部皮肤烫伤、气管和食管损伤、喉返神经损伤、颈部肌肉损伤导致的颈部外形改变和运动障碍。结论超声引导下甲状腺结节经皮热消融治疗安全性高,创伤小,可控性强,疗效确切,具有临床应用潜质。

Ultrasound-guided percutaneous thermal ablation of benign thyroid nodules: a clinical study

Objective To investigate the clinical effectiveness and safety of ultrasound-guided percutaneous thermotherapy for benign thyroid nodules. Methods Ultrasound-guided percutaneous radiofrequency or microwave ablation was conducted following tru-cut biopsy of 50 benign thyroid nodules in 40 patients, including those with adenomas and hyperplastic nodules.The necrosis and shrinkage in the ablated areas were evaluated.The adverse effects and complications related to ablation were observed. Results All the 50 thyroid nodules were deprived of blood supply after ablation as shown by contrast-enhanced ultrasound, and the ablated area completely covered the size of the nodules.Follow-up ultrasound examination demonstrated that the ablated areas were shrunk to various degrees, including completely disappearance in 6 (12%), 32(64%) with the diameters reduced by more than a half, and 12 (24%) with the diameters reduced by less than a half.There were no skin burns in the neck, bronchial or esophageal injuries, recurrent laryngeal nerve palsy, or complication related to neck muscle injury. Conclusion Ultrasound-guided percutaneous thermal ablation is a safe, minimally invasive, controllable and definitely effective method for treating benign thyroid nodules.It has a great clinical potential.