Abstract

Purpose: To compare results in patients treated with additional radiofrequency ablation (RFA) after clinical evaluation or vital volume (Va) increase.

Methods: Forty patients with 42 benign thyroid nodules who underwent additional RFA were evaluated in this retrospective study. According to the different indication for additional RFA, 18 patients were divided into Vv increase group (V group) and 22 into clinical evaluation group (C group). Patients were followed up at 1, 3, 6, 12 months and every 12 months thereafter by conventional ultrasound (US), contrast-enhancement ultrasound (CEUS) and clinical evaluation. Volume, volume reduction rate (VRR), symptom score and cosmetic score were evaluated before treatment and each ablation.

Results: After the first RFA, there were no statistically differences between two groups in volume, VRR, cosmetic and symptom scores. Compared with the first RFA, volume of all the patients after additional RFA decreased significantly (p < 0.001). In additional RFA, during a mean follow-up time of 10.15 ± 9.17 months, volume in V group was significantly smaller than in C group (2.84 ± 5.43 ml Vs 7.39 ± 13.01 ml, p = 0.046). VRR in V group was significantly larger than in C group (90.18 ± 12.74% Vs 75.66 ± 26.47%, p = 0.007) with significant improvement of cosmetic and symptom scores (p = 0.047; p = 0.030). No complications occurred after each session ablation.

Conclusion: Vv increase was a more reliable indicator for additional RFA than clinical evaluation. Additional RFA performed after Vv increase was more effective with respect to volume reduction and improvement of clinical outcomes. Therefore, Vv increase should be set as an indication for additional RFA.

摘要

目的：比较临床评估或增加生命体积（Va）后接受额外射频消融（RFA）治疗的患者的结果。

方法：这项回顾性研究评估了40例接受了附加RFA的42例甲状腺良性结节的患者。根据增加RFA的不同适应症，将18例患者分为Vv增加组（V组）和22例临床评估组（C组）。分别在1、3、6、12个月以及此后每12个月对患者进行常规超声（US），对比增强超声（CEUS）和临床评估。在治疗和每次消融之前，评估体积，体积减少率（VRR），症状评分和美容评分。

结果：第一次RFA后，两组的体积，VRR，美容和症状评分在统计学上无差异。与第一个RFA相比，接受额外RFA后所有患者的体积均显着减少（p  <0.001）。在额外的RFA中，平均随访时间为10.15±9.17个月，V组的体积显着小于C组（2.84±5.43 ml，而V组为7.39±13.01 ml，p  = 0.046）。V组的VRR显着高于C组（90.18±12.74％Vs 75.66±26.47％，p  = 0.007），美容和症状评分明显改善（p  = 0.047; p  = 0.030）。每次消融后均未发生并发症。

结论： Vv增加是比临床评估更可靠的RFA指标。Vv增加后进行的额外RFA在减少体积和改善临床结局方面更为有效。因此，应将Vv的增加设置为附加RFA的指示。