| Objective: To evaluate safety and efficacy of ultrasound-guided percutaneousmicrowave ablation (MWA) for benign thyroid lesions by analyzing the shrinking oflesions, the variance of ultrasound images, the laboratory examination for thyroidfunction, the clinical symptoms and cosmetic problems of the patients.Materials and Methods: From November2010to April2014, a total of76patients(mean age,47.1±13.0years) with88benign thyroid lesions (mean diameter,3.2±1.6cm)were treated with MWA in our department. Internally-cooled microwave antenna andsystems (KY2000, Kangyou Medical) were used in all patient’s therapy. We assessedthe initial size and microcirculation of lesions through ultrasound and drew up theablation plan before the procedure. Patient’s clinical symptoms (neck pain, dysphasia,foreign body sensation, discomfort, and cough), lesion’s ultrasound imaging feature(size and vascularity) and thyroid function were brought into observation. The varianceof those indicators above and the complications were recorded carefully during thewhole therapy (preoperative, intra-operative and postoperative period) and follow-uptime(regularly in1,3,6,12,24months).To evaluate objectively, symptom score,cosmetic score and vascularity scale as the quantitative methods were performed in ourstudy. We calculated the volume-reduction ratio (VRR) of the lesions by measuring itsinitial volume and volume at follow-up endpoint. It can be calculated according to theformula of ellipsoid volume. Related index were analyzed and compared by usingpaired sample t-test.Results: During the follow-up periods ranging from1to26months, thyroid lesion’s volumes were decreased from13.5±24.1ml before ablation to6.6±13.9ml after ablation,the VRR is51.23±31.97%.Vascularity scale and cosmetic score between pre-ablationand post-ablation were reduced significantly (P<0.01), as well as symptom scoredecreased with statistically significant difference (P=0.028) in the follow up period.Thyroid functional indicators changed in a transient period (about1to3days) aftertherapy, including T3, fT4increasing, and TSH decreasing which had statisticalsignificance compared with those of pre-ablation (P <0.01). The incidence of seriouscomplications is2.2%(2/92cases), including one case ipsilateral vocal cord palsy andone vascular injury.Conclusion: MWA is a safe, effective and minimally invasive new method in treatingbenign thyroid lesions. It can improve patient’s neck appearance with mild side effectsand acceptable complications. The multi-center study with large sample and long-termfollow-up would be needed to evaluate efficacy of MWA. Objective: To analyze the factors affecting the prevalence of goiter and epidemiologicalcharacteristics of thyroid nodules in Beijing residents. To discuss significance of thethermal ablation for thyroid lesions in epidemiological perspective. Materials andMethods: The numbers of10000permanent residents of Beijing urban and suburbanwere selected by Cluster sampling, age18-75years old, no serious organ damage. Wecollected the medical history, living habits physical conditions, ultrasound results ofthyroid by questionnaires and examination.Finally obtained complete information on6323cases, male2263, female4060, average age is51.44±11.72years old. Theprevalence and characteristics of thyroid goiter and nodules were accounted. And wefind out the related factors of the thyroid diseases. Results: The overall prevalence ofnodular and goiter which obtained by ultrasound screening is57.68%, female prevalence rate was significantly higher than men (p <0.001), and the prevalenceincreasing with age. The proportion of the multiple thyroid nodules in this populationshows difference between (p=0.001). Variety of factors is affecting the prevalence ofthyroid nodules in this area, age, sex, hypertension, diabetes, smoking were detectedsignificance in logistic model (p <0.05). Conclusion: The high prevalence of goiter andthyroid nodules in Beijing has been affected by many factors. Disease prevention andcontroling should focus on correcting habits and the underlying disease. Part of theexisting method is not fit for the whole patients. And some types of thyroid disease withunsatisfactory effect requires more reliable, repeatable and indications-extensivemethods. Objective: To conduct a prospective multi-center study with a large sample size tocompare efficacy, safety, reliability and clinical application, the main technique ofthermal ablation (MWA, RFA, LA) were included. Methods: From February2013toMay2014, a total of340patients (mean age,46.23±12.47years) with437benignthyroid lesions (mean diameter,2.7±1.4cm) were receiving ultrasound-guided thermalablation in12hospitals in China. Patients were divided into three groups by the ablationtechnique (RFA, MWA, LA) they took.We assessed the initial size and microcirculationof lesions through ultrasound and drew up the ablation plan before the procedure.Patient’s clinical symptoms (neck pain, dysphasia, foreign body sensation, discomfort,and cough), lesion’s ultrasound imaging feature (size and vascularity) and thyroidfunction were brought into observation. The variance of those indicators above and thecomplications were recorded carefully during the whole therapy (preoperative,intra-operative and postoperative period) and follow-up time(regularly in1,3,6,12,24months).To evaluate objectively, symptom score, cosmetic score and vascularity scale as the quantitative methods were performed in our study. We calculated thevolume-reduction ratio (VRR) of the lesions by measuring its initial volume and volumeat follow-up endpoint. It can be calculated according to the formula of ellipsoid volume.Related index were analyzed and compared by using paired sample t-test. Results:During the follow-up periods ranging from1to12months, the VRR of thyroid lesion is63.72±68.87%. Vascularity scale, symptom score and cosmetic score of all the patientsbetween pre-ablation and post-ablation were reduced significantly (P<0.01) in thefollow up period. Thyroid functional indicators changed in a transient period (about1to3days) after therapy, including T3, fT4increasing, and TSH decreasing which hadstatistical significance compared with those of pre-ablation (P <0.01). The number oflesions in the three groups (RFA, MWA, LA) respectively are236,199,3. Comparewith the group of RFA, group of MWA is obtained the shorter treatment time, andhigher VRR (p <0.05). Conclusion: Thermal ablation is a safe and effective newmethod in treating benign thyroid lesions. Interim results showed the progress of thisresearch has basically meet the initial expectations.The indicators taken into accountsuggested positive results, Nothing should be adjust in research Temporarily, but stillneed to supplement cases for laser ablation as a comparison reference. |
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