Modified ultrasound-guided percutaneous ethanol injection for treating cystic thyroid adenomas
- VernacularTitle:改良超声引导经皮注射无水乙醇治疗囊性甲状腺腺瘤
- Author:
Junhua ZHUO
;
Jianquan ZHANG
;
Xinhua LIU
;
Cai ZHAO
;
- Publication Type:Journal Article
- Keywords:
thyroid adenoma;
cyst;
percutaneous ethanol injection;
ultrasound guidance
- From:
Academic Journal of Second Military Medical University
2000;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To assess the technique, efficacy, security and side effects of percutaneous ethanol injection(PEI) in treating the cystic thyroid adenomas. Methods: Fifty seven patients(male 34, female 23) with unilateral and solitary benign cystic thyroid adenoma received PEI therapy under high resolution ultrasound guidance. The medial age of the patients was 47 years(ranging 29 62). The mean diameter in the largest section of the thyroid adenomas was (37.55?5.64) mm(17 59 mm). The thyroid lesions in 12 patients consisted of cystic lumen mixed with solid structure, and the rest 45 had entire cystic thyroid lesions. Ultrasound reexamination of thyroid lesions was done 3 months after the initial treatment. Significant curative effect was defined as an adenoma volume shrinkage rate larger than 50%. The efficacious result was defined as a volume shrinkage rate between 40% and 50% together with a further shrink over a 6 month duration follow up. Those patients with adenoma volume shrinkage rate less than 40% underwent a second PEI after 6 months. Results: Over a mean duration of 25.5 months follow up, 66.7% subjects with entirely cystic had significant curative outcome; 19.3% subjects had efficacious result; and 9.8% subjects needed a second PEI and their thyroid lesions contained more solid tissue. There were 5.3% subjects were transfered to open surgery due to colloid cyst fluid. Twenty one patients complained of intraoperative local transient pain; 15 patients had transient pyrexia in the 48 h after injection, and 3 patients were affected by post operative transient dysphonia. No serious bleeding were encountered, and no apparent change of serum T 3,T 4,TSH level was observed. Conclusion: Ultrasound guided PEI therapy is an effective, safe and simple procedure for the ablation of cystic thyroid adenoma. Careful selection of subjects according to their preoperative thyroid ultrasonographies can reduce the unsuccessful PEI. A selective volume of ethanol injection consistent with the adenoma size on sonograms and a thorough flush with ethanol can improve the efficacy of PEI.
