Application Value Of Elastography And SMI In Microwave Ablation Treatment For Papillary Thyroid Microcarcinoma

Chapter ? Ultrasound-guided Percutaneous Microwave Ablation in the Treatment of Papillary Thyroid Microcarcinoma:a Clinical Study on Efficacy and SafetyObjective:To evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation in the treatment of papillary thyroid microcarcinoma after 12 to 30 months of follow-up.Methods:Forty-three patients with pathologically confirmed papillary thyroid microcarcinoma(43 nodules)were treated with ultrasound-guided percutaneous microwave ablation and postoperatively treated with thyroid-stimulating hormone(TSH)suppressive therapy.Routine ultrasound examination,contrast-enhanced ultrasound,and thyroid function were performed at the 1st,3rd,6th,9th,12th,18th,24th,and 30th month after ablation,and the nodular images of each follow-up after preoperative and ablation were recorded by ultrasound to analyze the maximal diameter reduction ratio(MDRR),nodule volume reduction ratio(VRR),tumor-free survival rate,complications,and recurrence and metastasis of the postoperative ablation area,so as to analyze its treatment effectiveness and safety.Results:After 12 to 30 months of follow-up observation,the maximal diameter reduction ratio of the ablation area at the 24th month after ablation was 98.03%,and the ablation lesion volume reduction ratio reached 99.88%at the 24th month after ablation.Patients with tumor free survival rate reached 90.70%.The difference was statistically significant.No serious complications occurred.Only two cases of pain,one case of hemorrhage,and one case of temporary change in voice occurred.The overall complication rate was 7.3%.No thyroid recurrence or lymph node metastasis occurred.Conclusion:Ultrasound-guided percutaneous microwave ablation is safe and effective in the treatment of PTMC.It provides a PTMC patient who cannot tolerate surgical treatment or refuses surgical treatment or refuses regular follow-up observations a new alternative treatment,and therefore it is worthy of clinical promotion.Chapter ? Application Value of Elastography and SMI in Microwave Ablation Treatment for Papillary Thyroid MicrocarcinomaObjective:To prospectively analyze the reliability of ultrasonic elastography and superb micro-vascular imaging(SMI)in evaluating the efficacy of ultrasound-guided percutaneous microwave ablation for PTMC.Methods:Twenty-five patients who was performed ultrasound-guided fine needle aspiration biopsy(FNAB)cytopathological results proved to be a PTMC and then operated ultrasound-guided percutaneous microwave ablation in our ultrasound department from January 2016 to December 2017 and followed up of ultrasonic elastography and SMI were confirmed.At the 1st,3rd,6th,9th,and 12th month after ablation,ultrasonic elastography,SMI,and contrast-enhanced ultrasound(CEUS)have been performed on ablation lesions to evaluate the changes in the elastic strain rate(SR)at the center of ablation lesions at different times and the blood flow distribution of ablation lesions.Results:The ratio of elastic imaging strain rate(SR)between the central area of ablation lesions and surrounding normal thyroid parenchyma after percutaneous microwave ablation for PTMC at 1st,3rd,6th,9th,and 12th month were 28.56±5.04,20.48±4.22,14.35±2.64,8.67±2.05,and 3.35± 1.03,respectively.The 3rd,6th,9th,and 12th months after operation were There was a statistically significant difference between the SR ratios at the 1st month and the 3rd,6th,9th,and 12th month after ablation.Evaluation of blood flow distribution in microcirculation of PTMC ablated lesions at 1st,3rd,6th,9th,and 12th month after ultrasound-guided percutaneous microwave ablation,was tested by cSMI,mSMI,and CEUS,respectively.The McNemar paired chi-square test was performed between the blood flow distribution types.The p-values were all greater than 0.05,and the difference was not statistically significant.Conclusion:Ultrasonic elastography can be used to evaluate the elasticity of the central region of PTMC ablation lesions after ultrasound-guided percutaneous microwave ablation.With the passage of time,its elasticity gradually increases and the hardness gradually becomes softer.SMI can be used to evaluate the microcirculation perfusion of PTMC ablation lesions after ultrasound-guided percutaneous microwave ablation.And it is applied without contrast agent,non-invasively,simplely and economically so as to be worthy of clinical promotion.