超声造影在甲状腺结节消融术前及术后评价消融疗效

A Clinical Study on the Efficacy of Contrast-enhanced Ultrasound in Preoperative and Postoperative Ablation of Thyroid Nodules

目的探讨超声造影在甲状腺结节消融术前及术后评价消融疗效的临床应用价值。方法选取昆明市延安医院2017年1月至2018年5月行微波消融治疗的72例甲状腺良性结节患者为研究对象,按照随机数字表法将其分为研究组和对照组各36例,研究组在微波消融术前及术后应用超声造影监控指导,观察患者结节坏死范围,判断是否完全消融,对照组在微波消融术前及术后应用常规彩色多普勒超声进行监控指导,对两组患者甲状腺结节消融灶体积及体积缩小率进行比较,统计分析两组患者甲状腺结节完全消融率及术后1年内的结节复发情况。结果两组术前甲状腺结节体积比较,差异无统计学意义(P>0.05);研究组在术后1个月、3个月、6个月及12个月甲状腺结节消融灶体积明显较对照组小(P<0.05);研究组术后1个月、3个月、6个月及12个月甲状腺结节消融灶体积缩小率明显较对照组高(P<0.05);研究组完全消融率与对照组相比明显较高,且术后1年内结节复发率明显较对照组低(P<0.05)。结论超声造影用于甲状腺结节微波消融术前能够有效监控消融范围,提高完全消融率,降低结节复发率,可为术后评价消融疗效及结节复发风险提供重要指导,值得临床进一步推广应用。

Objective To evaluate the clinical value of CEUS in evaluating the efficacy of ablation of thyroid nodule before and after ablation.Methods A total of 72 patients with benign thyroid nodules who underwent microwave ablation in kunming yanan hospital from January 2017 to May 2018 were selected as the research subjects.According to the random number table method,they were divided into study group and control group,36 cases each.The study group was given contrast-enhanced ultrasound monitoring and guidance before and after microwave ablation to observe the extent of nodular necrosis and to determine whether complete ablation was performed.The control group was monitored and guided by conventional color doppler ultrasound before and after microwave ablation.The volume and reduction rate of thyroid nodule ablation were compared between the two groups,and the complete ablation rate of thyroid nodule and the recurrence of nodule within 1 year after operation were statistically analyzed.Results There was no significant difference in the preoperative thyroid nodule volume between the two groups(P>0.05).The volumes of thyroid nodule ablation in the study group were significantly smaller than those in the control group at 1,3,6 and 12 months after surgery(P<0.05).The volume reduction rates of thyroid nodule ablation at 1 month,3 months,6 months and 12 months after surgery in the study group were significantly higher than those in the control group(P<0.05).The total ablation rate of the study group was significantly higher than that of the control group,and the recurrence rate of nodules within 1 year after surgery was significantly lower than that of the control group(P<0.05).Conclusions CEUS can effectively monitor the ablation range before microwave ablation of thyroid nodules,improve the complete ablation rate and reduce the recurrence rate of nodules,which can provide important guidance for postoperative evaluation of ablation efficacy and recurrence risk of nodules,and is worthy of further clinical application.