2017 年第 10 期 第 12 卷

超声造影在甲状腺良性结节患者射频导管消融治疗中的应用价值

Application value of contrast-enhanced ultrasound in radiofrequency ablation treating benign thyroid nodules

作者：薛少伟罗渝昆费翔李楠

英文作者：Xue Shaowei Luo Yukun Fei Xiang Li Nan

单位：100853北京，解放军总医院超声科

英文单位：Department of Ultrasonography Chinese PLA General Hospital Beijing 100853 China

关键词：甲状腺良性结节；超声造影；射频导管消融；甲状腺激素

英文关键词：Benignthyroidnodule;Contrast-enhancedultrasound;Radiofrequencycatheterablation;Thyroidhormone

• 摘要：

• 目的 探讨超声造影在甲状腺良性结节患者射频导管消融治疗中的应用价值。方法 采用连续性随机抽样方法选取2014年11月至2016年12月解放军总医院收治的甲状腺良性结节患者90例作为研究对象。入选患者均于超声造影引导下采用射频导管消融治疗。比较治疗前后患者甲状腺激素水平、甲状腺结节造影情况及临床治疗预后情况。结果 治疗后患者血清三碘甲状腺原氨酸、甲状腺素、游离三碘甲状腺原氨酸、游离甲状腺素均高于治疗前，促甲状腺激素低于治疗前，差异均有统计学意义［（1.60±0.22）μg/L比（1.52±0.19）μg/L、（101±18）μg/L比（93±16）μg/L、（3.3±0.6）μg/L比（3.1±0.6）μg/L、（14.2±1.8）μg/L比（12.2±1.2）μg/L、（1.4±0.8）mU/L比（1.6±0.8）mU/L］（均P<0.05）。术前114个甲状腺良性结节均伴有不同程度的造影增强，射频导管消融治疗后所有的结节斑点样增强或无增强。治疗后即刻、治疗后1、3、6、12个月彩色血流评分均低于治疗前［（0.21±0.11）、（0.21±0.11）、（0.00±0.00）、（0.00±0.00）、（0.00±0.00）分比（2.02±0.47）分］，差异均有统计学意义（均P<0.05），但治疗后各时点间两两比较差异均无统计学意义（均P>0.05）。90例患者恢复良好率为91.1%（82/90），手术失败率为5.6%（5/90），治疗过程中并发症发生率为2.2%（2/90）。结论 超声造影可提高甲状腺良性结节患者射频导管消融治疗精度，促进患者甲状腺功能恢复。

• Objective To investigate the value of contrast-enhanced ultrasound in radiofrequency ablation treating benign thyroid nodules. Methods Ninety patients with benign thyroid nodules were successively enrolled from November 2014 to December 2016 in Chinese PLA General Hospital. All patients had contrast-enhanced ultrasound guided radiofrequency ablation. Changes of thyroid hormone and thyroid nodule contrastographic image were analyzed. Clinical prognosis was evaluated. Results Levels of serum triiodothyronine, thyroxine, free three triiodothyronine and free thyroxine after treatment were significantly higher and the level of thyroid stimulating hormone was significantly lower than those before treatment［（1.60±0.22）μg/L vs （1.52±0.19）μg/L, （101±18）μg/L vs （93±16）μg/L, （3.3±0.6）μg/L vs （3.1±0.6）μg/L, （14.2±1.8）μg/L vs （12.2±1.2）μg/L, （1.4±0.8）mIU/L vs （1.6±0.8）mIU/L］（P＜0.05）. One hundred and fourteen thyroid nodules with contrast enhancement before treatment showed contrast diminishment after radiofrequency ablation. The color flow score immediately and 1, 3, 6, 12 months after treatment was significantly lower than that before treatment［（0.21±0.11）,（0.21±0.11）,（0.00±0.00）,（0.00±0.00）,（0.00±0.00）scores vs （2.02±0.47）scores］（P＜0.05）; there were no significant differences of the color flow score among all post-treatment time points（P＞0.05）. The good recovery rate in 90 patients was 91.1%（82/90）; the operative failure rate was 5.6%（5/90）; the complication rate was 2.2%（2/90）. Conclusion Contrast-enhanced ultrasound guiding helps improve the accuracy of radiofrequency ablation in patients with benign thyroid nodules and promote thyroid function recovery.