超声引导下冷循环微波消融治疗甲状腺微小癌的临床价值

The clinical value of cold-tip microwave ablation treatment of thyroid microcarcinoma under ultrasound guidance

目的探讨B超引导下经皮冷循环微波消融（MA）治疗甲状腺微小癌的临床价值。方法疑为甲状腺微小癌（病灶直径〈10mm）患者12例，12个病灶，均无淋巴结转移且患者希望首选非开放手术治疗。治疗前先行组织学穿刺活检，之后在超声引导下进行甲状腺病灶的经皮穿刺冷循环MA治疗，MA后应用超声造影进行定期随访。结果所有患者治疗后恢复顺利，无术后声音嘶哑、喝水呛咳等并发症。所有患者均得到随访，随访时间12～18个月。超声造影检查显示消融区域范围缩小，甲状腺及周围淋巴结未见甲状腺癌的复发和其他异常的影像学表现。结论MA治疗无淋巴结转移的甲状腺微小癌安全、有效，具有创伤小、美观、术后恢复快等优点。

Objective To investigate the clinical value of cold-tip microwave ablation （MA） treatment of thyroid microcarcinoma under ultrasound guidance. Methods 12 patients with 12 lesions were selectedwho have thyroid micro carcinoma（ tumor diameter less than 10 ram） showed by uhrasonogra- phy, no lymph node metastasis and prefer non-surgical treatment. Core needle histological biopsy was done before MA;then the patients were treated by MA under ultrasound guidance, all the patients were followed up regularly by ultrasound scan. Results All patients recovered well after treatment, no postoperative hoarseness,drinking cough and other complications. All patients were followed up for 12 to 18 months. Contrast-enhanced ultrasound showed that ablation region narrowed, no recurrence of thyroid cancer and other abnoimal imaging findings were found in thyroid and surrounding lymph nodes. Conclusion MA can be used as a safe and effective treatment for thyroid microcarcinoma without lymph node metastasis. MA is a minimally invasive surgical approach with advantages such as fewer traumas, better appearance and quicker recovery.