Abstract

Objective: The purpose of this study was to evaluate the usefulness of CT for quantitative assessment of the neck structures after RFA in patients with benign thyroid nodules.

Materials and methods: This single-center, retrospective cohort study included 38 patients with benign thyroid nodules who had received RFA and had available pre- and post-treatment CT images. Changes in the tracheal anteroposterior (AP)/transverse diameter ratio, cross-sectional tracheal area, midline deviation of the trachea, and anterior neck angle after RFA were quantitatively measured using CT. Volume reduction rates (VRRs) for the thyroid gland and nodules were measured using CT and US, respectively, and the intraclass correlation coefficient (ICC) was calculated. The paired Wilcoxon signed-rank test was used to compare pre- and post-treatment CT-based measurements, and univariate linear regression analysis was performed to determine the association of VRR with the mean delivered radiofrequency energy, number of RFA sessions, and initial thyroid volume.

Results: After RFA, the tracheal AP/transverse diameter ratio and midline deviation were significantly decreased while the tracheal area and anterior neck angle were significantly increased (all, p < 0.001). The thyroid volume reduction was also significant (VRR, 42.1% ± 21.1%, p < 0.001), with moderate consistency between the CT-based thyroid VRR and US-based nodule VRR (ICC = 0.68, 95% confidence interval = 0.38–0.83, p < 0.001). The mean delivered radiofrequency energy (p = 0.565), number of RFA sessions (p = 0.209), and initial thyroid volume (p = 0.363) showed no significant association with VRR.

Conclusion: CT-based quantitative assessments may be useful for evaluating improvements in the neck structures after RFA for benign thyroid nodules.

摘要

目的：本研究的目的是评估CT对定量分析良性甲状腺结节患者RFA后颈部结构的有用性。

材料和方法：这项单中心，回顾性队列研究纳入了38位甲状腺良性结节患者，这些患者接受了RFA并可获得治疗前后的CT图像。使用CT定量测量RFA后气管前后（AP）/横向直径比，气管横截面积，气管中线偏差和前颈角的变化。使用CT和US分别测量甲状腺和结节的体积缩小率（VRR），并计算组内相关系数（ICC）。配对的Wilcoxon符号秩检验用于比较治疗前和治疗后基于CT的测量，并进行单变量线性回归分析以确定VRR与平均递送射频能量，RFA疗程数和初始甲状腺的关系卷。

结果： RFA后，气管AP /横径比和中线偏差显着降低，而气管面积和前颈角显着增加（所有，p  <0.001）。甲状腺体积减少也很明显（VRR，42.1％±21.1％，p  <0.001），基于CT的甲状腺VRR和基于US的结节VRR具有中等一致性（ICC = 0.68，95％置信区间= 0.38–0.83） ，p  <0.001）。平均递送的射频能量（p  = 0.565），RFA疗程数（p  = 0.209）和初始甲状腺体积（p  = 0.363）与VRR无关。

结论：基于CT的定量评估可能对评估良性甲状腺结节RFA后颈部结构的改善有用。