乙醇消融与射频消融治疗甲状旁腺瘤疗效的评价与比较

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2025-07-18 DOI:10.1016/j.crad.2025.107016

P. Rezvanian , B. Tavakoli , A. Feizi , S. Etezazian , H. Rezvanian

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引用次数: 0

摘要

甲状旁腺切除术是原发性甲状旁腺功能亢进（PHPT）的标准治疗方法，与并发症相关，对于有明显合并症的患者可能不可行。本研究旨在评价和比较乙醇消融（EA）和射频消融（RFA）治疗甲状旁腺瘤的疗效。材料与方法本研究纳入133例PHPT患者，其中76例行RFA， 57例行EA。随访1个月和6个月后评估血清钙、磷和甲状旁腺激素（PTH）水平。一个月后随访超声检查评估腺瘤体积。结果rfa导致血清PTH、钙水平和腺瘤大小显著降低，血清磷水平显著升高（p < 0.001）。同样，EA导致血清PTH、钙和腺瘤体积的显著降低（P < 0.001），而磷水平的变化是显著的（P=0.063）。随访结束时，RFA组95.2%的患者和EA组97.6%的患者达到正常钙血症。两种治疗方法在降低血清PTH、钙水平和腺瘤体积方面均显示出相当的效果（P=0.35、P=0.22和P=0.76）。然而，RFA在提高磷水平方面更有效（P=0.005）。结论RFA和EA均是治疗PHPT的有效方法，可替代甲状旁腺切除术。这些微创技术在降低血清PTH、钙和腺瘤体积方面的效果相似，RFA对磷水平的影响更大。

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Evaluation and comparison of ethanol ablation and radiofrequency ablation therapeutic effects on parathyroid adenoma

Aim

Parathyroidectomy, the standard treatment for primary hyperparathyroidism (PHPT), is associated with complications and may not be feasible for patients with significant comorbidities. This study aims to evaluate and compare the efficacy of ethanol ablation (EA) and radiofrequency ablation (RFA) in the treatment of parathyroid adenoma.

Materials and methods

This retrospective study included 133 patients with PHPT, 76 of whom underwent RFA and 57 underwent EA. Serum calcium, phosphorus, and parathyroid hormone (PTH) levels were evaluated after one and six months of follow-up. A follow-up ultrasound exam was conducted after one month to assess adenoma volume.

Results

RFA resulted in significant reductions in serum PTH, calcium levels, and adenoma size, as well as a significant increase in serum phosphorus levels (all P<0.001). Similarly, EA led to substantial reductions in serum PTH, calcium, and adenoma volume (all P<0.001), while the changes in phosphorus levels were borderline significant (P=0.063). At the end of the follow-up period, 95.2% of patients in the RFA group and 97.6% in the EA group achieved normocalcemia. Both treatments showed comparable effectiveness in reducing serum PTH, calcium levels, and adenoma volume (P=0.35, P=0.22, and P=0.76, respectively). However, RFA was significantly more effective in increasing phosphorus levels (P=0.005).

Conclusion

Both RFA and EA are highly effective alternatives to parathyroidectomy for treating PHPT. These minimally invasive techniques offer similar outcomes in terms of reducing serum PTH, calcium, and adenoma volume, with RFA showing a superior effect on phosphorus levels.

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来源期刊

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.