光学导航辅助甲状腺结节消融治疗的可行性研究

Feasibility study on optical navigation assisted cryoablation of thyroid nodules

目的:通过动物实验探索光学导航结合超声导航进行甲状腺结节消融治疗的可行性,选择冷冻消融作为手段,并在动物实验中验证定位的准确度以及消融安全性。方法:通过超声引导对3只巴马小香猪的甲状腺腺体进行消融,建立甲状腺结节的动物模型。应用光学导航对“结节”及甲状腺进行三维超声重建,低年资超声介入科医师通过光学导航引导消融针尖精准穿刺。消融针道穿过“结节”中心至“结节”前缘,开启冷冻消融,直到冰球范围超出结节边缘5 mm以上。分别记录“结节”大小、消融参数、冰球以及消融灶范围、术后并发症等。结果:光学结合超声导航辅助下,低年资超声介入医师可顺利地将消融针穿过“结节”中心至“结节”前缘靶目标。冰球平均直径约为(24.3±3.8)mm,消融术后30 min冰球完全融化,复查甲状腺彩超显示消融灶最大径平均为(18.7±5.1)mm,体积为(2215.4±1470.3)mm^(3)。无并发症发生。结论:光学结合超声导航进行甲状腺结节冷冻消融安全有效,对邻近关键结构损伤较小。光学导航可帮助低年资超声介入科医师顺利完成甲状腺结节冷冻消融,具有良好的应用前景。

Objective:To explore the feasibility of optical navigation combined with ultrasound navigation for thyroid nodule ablation through animal experiments,selecting cryoablation as a means,and verifying the accuracy of localization and ablation safety in animal experiments.Methods:Three Bama Xiaoxiang pigs were ablated with ultrasound guidance to establish an animal model of thyroid nodules.Using optical navigation for three-dimensional ultrasound reconstruction of“nodules”and thyroid,young ultrasound intervention physicians used optical navigation to guide precise ablation needles puncture.The ablation needles passed through the center of the“nodules”to the front edge of the“nodules”,and cryoablation was initiated until the range of the ice balls exceeded the edge of the nodules by more than 5 mm.Recorded the size of the nodules,ablation parameters,ice hockey and ablation range,and postoperative complications separately.Results:With the assistance of optical and ultrasound navigation,inexperienced ultrasound interventional physicians could smoothly pass the ablation needles through the center of the“nodules”to the front edge target of the“nodules”.The average diameter of the ice balls was about(24.3±3.8)mm.After 30 min of ablation,the ice balls completely melt.Follow up thyroid ultrasound showed that the maximum diameter of the ablation lesions was on average(18.7±5.1)mm,and the volume was(2215.4±1470.3)mm^(3).All experimental animals had no complications.Conclusion:The combination of optical and ultrasound navigation for thyroid nodule cryoablation was safe and effective,with minimal damage to adjacent critical structures.Optical navigation can help inexperienced ultrasound interventional physicians successfully complete thyroid nodule cryoablation,and has good application prospects.