多模态超声技术在微波消融治疗甲状腺结节中的价值研究

The value of multimodal ultrasound technology in the treatment of thyroid nodulesby microwave ablation

目的:探讨多模态超声技术在甲状腺良性结节微波消融治疗随访的价值。方法:选取74例甲状腺良性结节患者(86枚病灶)为研究对象。每例患者在术前与术后1、3、6、12个月随访时进行常规超声、微血管成像及剪切波弹性成像检查,并记录结节及消融灶的位置、大小、回声、形态、边界、血流信号、剪切波弹性成像杨氏模量值及微血管成像情况。结果:常规超声显示消融治疗前后病灶周围正常甲状腺组织没有改变,治疗后消融灶的体积随时间延长进行性减小,第12个月有17例患者的20枚消融灶完全消失。微血管成像技术:术后随访中仅2例患者的3枚消融灶在术后1个月显示边缘局部出现短棒状微血管分布,对该病灶残留区追加微波消融,再次随访时消融灶未见微血管分布。剪切波弹性成像:术后随访中发现消融灶的杨氏模量值呈先增高后减低的趋势,术后1、3、6个月消融灶的杨氏模量值较术前增高,差异有统计学意义(P<0.05)。结论:多模态超声技术在甲状腺结节微波消融治疗的术前预估及术后疗效随访中具有肯定价值,对促进微波消融治疗甲状腺结节具有积极的临床推广意义。

Objective:To investigate the follow-up value of multimodal ultrasound technologyin the treatment of benign thyroid nodules by microwave ablation.Methods:To select 74 patients(86 lesions)with benign thyroid nodules as the object of study.Routine ultrasound,shear wave elastography,microvascular imagingwere performed before and 1,3,6 and 12 months follow-up after operation,and the changes in position,size,echogenicity,shape,margins,CDFI,shear wave elastographyand microvascular imaging of the thyroid nodules were recorded in detail.Results:Routine ultrasound showed that there nothing had changed in normal thyroid tissue around the lesions before and after ablation,the volume after ablation decreased gradually with time,and 20 ablation lesions disappeared completely in 17 patients at the twelfth month of follow-up.Microvascular Imaging technique:at the first month during follow-up after ablation,only 3 lesions of 2 patients showed the distribution of short rodlike microvessels at the edge of ablation lesions.Microwave ablation was added to the residual area of the lesion,and no microvessels were found during the second follow-up.Shear wave elastography:during the follow-up,it was found that the Young’s modulus of aelastic shear wave increased at first and then decreased,and the Young’s modulus of ablation lwsions increased at 1,3 and 6 months after operation.It was significantly higher than that before operation,and the difference was statistically significant(P<0.05).Conclusion:Multimodal ultrasound technology has positive value in preoperative prediction and postoperative follow-up of microwave ablation for thyroid nodules and has a positive clinical significance in promoting microwave ablation in the treatment of thyroid nodules.