<br>射频消融治疗≤2cm Bethesda IV甲状腺结节的减容率,European Radiology

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射频消融治疗≤2cm Bethesda IV甲状腺结节的减容率
European Radiology ( IF 4.7 ) Pub Date : 2023-09-04 , DOI: 10.1007/s00330-023-10185-2
YiJie Dong ₁ , WeiWei Zhan ₁ , JianQiao Zhou ₁ , Ning Li ₂ , ZhenHua Liu ₁ , ShuJun Xia ₁ , XiaoFeng Ni ₁ , Juan Liu ₁ , JingWen Zhang ₁ , ShangYan Xu ₁ , ZhiFang Yang ₁ , Qing Hua ₁

Affiliation

客观的

这项前瞻性观察性研究旨在通过 Bethesda IV 细胞学和 C-TIRADS 4A 分类评估射频消融 (RFA) 治疗 ≤ 2 cm 甲状腺结节的疗效。此外，还检查了影响消融完全吸收（CAA）的因素。

方法

共有 62 例 62 个结节接受了超声引导下 RFA 治疗，并纳入该研究。在第1次、第3次、第6次以及随后的6个月随访时评估体积减少率（VRR）、CAA和消融不完全吸收（IAA）。在第 12 个月的随访中比较 CAA 组和 IAA 组的临床和超声特征。

结果

第1、3、6、12个月和末次随访时的平均VRR分别为-88.6%、16.0%、59.7%、82.0%和98.2%。 RFA 一年后，超过一半的结节达到 90% VRR，其中 88.7% 在研究结束时表现出 CAA（随访时间为 14 至 63 个月）。具有 3 级血管分布的结节和与慢性甲状腺炎相关的结节在第 12 个月的随访中显示出 CAA 延迟（分别为p = 0.036 和 0.003）。

结论

通过 Bethesda IV 细胞学检查和 C-TIRADS 4A 分类，RFA 是治疗 ≤ 2 cm 甲状腺结节的有效技术。具有 3 级血供的结节和慢性甲状腺炎患者对 RFA 后的完全吸收有影响。

临床相关性声明

我们的研究表明，射频消融对于细胞学分类为 Bethesda IV 细胞学的 ≤ 2 cm 甲状腺结节是一种有效的治疗方法。然而，我们发现结节的高血管分布和慢性甲状腺炎是影响消融完全吸收的不利因素。

关键点

•射频消融(RFA) 是治疗≤2 cm Bethesda IV 类甲状腺结节的有效技术。

•较高的血液供应和慢性甲状腺炎会影响RFA 后的完全吸收。

"点击查看英文标题和摘要"

Volume reduction rate of radiofrequency ablation in ≤ 2 cm Bethesda IV thyroid nodules

Objective

This prospective observational study aimed to evaluate the efficacy of radiofrequency ablation (RFA) in treating ≤ 2 cm thyroid nodules with Bethesda IV cytology and C-TIRADS 4A categorization. Additionally, the factors influencing the completed absorption of ablation (CAA) were examined.

Methods

A total of 62 cases with 62 nodules underwent ultrasound-guided RFA and were included in the study. The volume reduction rate (VRR), CAA, and incomplete absorption of ablation (IAA) were assessed at the 1st, 3rd, 6th, and subsequent 6-month follow-ups. Clinical and ultrasound features were compared between the CAA and IAA groups at the 12th month follow-up.

Results

The average VRR at the 1st, 3rd, 6th, 12th month, and last follow-up were −88.6%, 16.0%, 59.7%, 82.0%, and 98.2%, respectively. More than half of the nodules achieved a 90% VRR after 1 year of RFA, with 88.7% demonstrating CAA at the end of the study (follow-up duration of 14 to 63 months). Nodules with grade 3 vascularity and those associated with chronic thyroiditis showed delayed CAA at the 12th month follow-up (p = 0.036 and 0.003, respectively).

Conclusion

RFA is an effective technique for treating ≤ 2 cm thyroid nodules with Bethesda IV cytology and C-TIRADS 4A categorization. Nodules with grade 3 blood supply and patients with chronic thyroiditis exhibited an impact on the completed absorption following RFA.

Clinical relevance statement

Our study has shown that radiofrequency ablation is an effective treatment for ≤ 2 cm thyroid nodules classified as Bethesda IV cytology. However, we identified that high vascularity of the nodule and chronic thyroiditis are adverse factors affecting the completed absorption of the ablation.