超声引导下射频消融治疗甲状腺良性结节27例  

Ultrasound-guided radiofrequency ablation for the treatment of benign thyroid nodules:preliminary results in 27 cases

作　　者：张燕[1] 章美武[1] 范晓翔[1] 

机构地区：[1]浙江宁波市第二医院介入科,315010

出　　处：《介入放射学杂志》2016年第2期136-140,共5页Journal of Interventional Radiology

基　　金：浙江省区域专病中心建设学科项目(2014-98)

摘　　要：目的探讨超声引导下经皮射频消融(RFA)治疗甲状腺良性结节的临床效果。方法选取2012年12月至2014年11月在超声引导下行经皮RFA术治疗的27例甲状腺结节患者,术后1、3、6个月超声观察病灶变化,计算体积及病灶缩小率,彩色多普勒血流成像(CDFI)和超声造影检测病灶血流信号消失程度。结果经皮RFA术均成功,无中转开放手术,术后造影病灶处均无血流灌注;术中感牙痛2例,停止消融牙痛即缓解。1例消融后有声音嘶哑,未处理,3个月后声音恢复。RFA治疗后1、3、6个月,结节体积均有不同程度的缩小,CDFI和超声造影检测病灶内均无血流信号和血流灌注,与治疗前比较差异均有统计学意义(P<0.05)。在随访过程中,消融区未出现对比剂重新填充的现象。高频超声检查显示,3枚结节在术后6个月完全消失,22枚结节消融于1年后直径缩小1/2,8枚结节消融于1年后直径缩小至不足1/2。与术前比较,治疗后1年内,所有结节直径明显缩小,数据具有统计学意义(P<0.05)。术后1周甲状腺功能指标有明显改变,术后1个月恢复术前水平。结论超声引导下的RFA治疗能有效缩小并使其结节性甲状腺肿结节体积及直径消失,并发症较少,不影响甲状腺功能,创伤小,临床效果显著,是一种可行、安全、有效的治疗方法。Objective To investigate the clinical effect of ultrasound-guided radiofrequency ablation （RFA） for the treatment of benign thyroid nodules. Methods A total of 27 patients with benign thyroid nodules, who were treated with nhrasound-guided pereutaneous RFA during the period from December 2012 to November 2014, were included in this study. The changes of lesions were determined by ultrasound at one, 3 and 6 moths after RFA, the volume and the reduction rate of the lesions were calculated, the weakened degrees of blood flow signals were measured by color Doppler flow imaging （CDFI） and ultrasonography. Results Percutaneous RFA was successfully accomplished in all patients; no patient needed to be transferred for open operation; postoperative angiography showed that no blood flow perfusion was observed. In operation, 2 patients felt toothache, and the toothache was relieved when ablation was ceased. One patient had hoarseness after ablation, and without special treatment his voice returned to normal in 3 months. At one, 3 and 6 months after RFA, the nodules were reduced in different degrees; CDFI and ultrasonography revealed that there was neither blood flow signals nor blood perfusion within the lesions, and compared with the preoperative manifestations these changes were statistically significant （P〈0.05）. During the follow-up period, the phenomenon of contrast agent re- filling in the ablated areas was not observed,which reasonably indicated that no blood vessels were formed. High frequency ultrasound examination showed that 3 nodules completely disappeared in 6 months after RFA, 22 nodules were reduced to 1/2 in diameter after one year, and 8 nodules were reduced to less than 1/2 in diameter after one year. Compared to the preoperative findings, all nodules were significantly reduced within one year after RFA, the differences were statistically significant （P〈O.05）. One week after RFA the indexes of thyroid function were obviously changed, and one month after RFA the indexes of thyroid functi

关 键 词：超声 射频消融 结节性甲状腺肿 

分 类 号：R581[医药卫生—内分泌]