Abstract

Objective

This retrospective study aimed to investigate the efficacy and safety of partial ablation (PA) for benign thyroid nodules (BTNs) using microwave ablation (MWA) in a long-term follow-up.

Materials and methods

Between February 2015 and April 2019, 236 patients with 236 BTNs (maximum diameter ≥2 cm) treated with ultrasound-guided MWA were enrolled. Contrast-enhanced ultrasound (CEUS) was performed within 3 d after ablation to determine whether there was residual tissue according to which the patients were assigned PA or complete ablation (CA). The volume reduction ratio (VRR) and complications were evaluated during follow-up.

Results

Eighty-two patients were enrolled in the PA group, and 154 were enrolled in the CA group. Both groups achieved continuous reductions in nodule volume and increases in VRR within 2 years after ablation. Although the VRR of the PA group at 4 years was lower than that of the CA group (65.54 vs. 95.08%; p<.05), PA still achieved ‘technical efficacy’ with a volume reduction of more than 50%. The complication and side effect rates between the two groups showed no significant difference (p>.05).

Conclusions

Both PA and CA were safe and effective in reducing the volumes of BTNs in the long-term follow-up. For nodules with a large initial volume and dangerous location, PA with a small amount of residual tissue may be acceptable.

中文翻译：

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甲状腺良性结节适合部分消融吗？微波消融术后长期随访的回顾性研究

摘要

客观的

这项回顾性研究旨在长期随访中研究使用微波消融 (MWA) 进行部分消融 (PA) 治疗良性甲状腺结节 (BTN) 的有效性和安全性。

材料和方法

2015 年 2 月至 2019 年 4 月期间，纳入了 236 名接受超声引导 MWA 治疗的 236 名 BTN（最大直径≥2 cm）患者。消融后 3 d 内进行对比增强超声 (CEUS) 以确定是否存在残余组织，根据患者分配 PA 或完全消融 (CA)。在随访期间评估容积减少率（VRR）和并发症。

结果

PA组82例，CA组154例。两组均在消融后 2 年内实现了结节体积的持续减少和 VRR 的增加。尽管 PA 组在 4 年时的 VRR 低于 CA 组（65.54 对 95.08%；p <.05），但 PA 仍然达到了“技术效果”，体积减少了 50% 以上。两组并发症及副作用发生率无显着差异（p> .05）。

结论

在长期随访中，PA 和 CA 在减少 BTN 的体积方面都是安全有效的。对于初始体积较大且位置危险的结节，可以接受少量残留组织的PA。