{"title":"囊性甲状腺结节的治疗","authors":"Kepal N. Patel MD , Catherine Sinclair MD","doi":"10.1016/j.tvir.2022.100822","DOIUrl":null,"url":null,"abstract":"<div><p><span><span>The optimal treatment option for cystic </span>thyroid lesions depends on the composition of the lesion, prior interventions, and patient preference. Simple aspiration is a good initial diagnostic and treatment modality for thyroid lesions that are predominantly cystic. However, recurrence rates are high and, should fluid re-accumulate, further aspirations are unlikely to be effective. Ethanol ablation is an excellent first line treatment as it is relatively safe, well-tolerated, and simple to perform. It is at least as effective, if not more effective, than </span>radiofrequency ablation<span> (RFA) for simple cysts, and complex thyroid cysts with a solid component <20%. The efficacy of EA is inversely related to the percentage of solid component within any given lesion. There is some evidence that complex cysts with >20% solid component may have better long-term outcomes with RFA over EA, although EA is still a reasonable first line consideration. RFA salvage after EA is possible and effective, especially for complex nodules with larger solid components.</span></p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Treatment of cystic thyroid nodules\",\"authors\":\"Kepal N. Patel MD , Catherine Sinclair MD\",\"doi\":\"10.1016/j.tvir.2022.100822\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p><span><span>The optimal treatment option for cystic </span>thyroid lesions depends on the composition of the lesion, prior interventions, and patient preference. Simple aspiration is a good initial diagnostic and treatment modality for thyroid lesions that are predominantly cystic. However, recurrence rates are high and, should fluid re-accumulate, further aspirations are unlikely to be effective. Ethanol ablation is an excellent first line treatment as it is relatively safe, well-tolerated, and simple to perform. It is at least as effective, if not more effective, than </span>radiofrequency ablation<span> (RFA) for simple cysts, and complex thyroid cysts with a solid component <20%. The efficacy of EA is inversely related to the percentage of solid component within any given lesion. There is some evidence that complex cysts with >20% solid component may have better long-term outcomes with RFA over EA, although EA is still a reasonable first line consideration. RFA salvage after EA is possible and effective, especially for complex nodules with larger solid components.</span></p></div>\",\"PeriodicalId\":51613,\"journal\":{\"name\":\"Techniques in Vascular and Interventional Radiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2022-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Techniques in Vascular and Interventional Radiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1089251622000270\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Vascular and Interventional Radiology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1089251622000270","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
The optimal treatment option for cystic thyroid lesions depends on the composition of the lesion, prior interventions, and patient preference. Simple aspiration is a good initial diagnostic and treatment modality for thyroid lesions that are predominantly cystic. However, recurrence rates are high and, should fluid re-accumulate, further aspirations are unlikely to be effective. Ethanol ablation is an excellent first line treatment as it is relatively safe, well-tolerated, and simple to perform. It is at least as effective, if not more effective, than radiofrequency ablation (RFA) for simple cysts, and complex thyroid cysts with a solid component <20%. The efficacy of EA is inversely related to the percentage of solid component within any given lesion. There is some evidence that complex cysts with >20% solid component may have better long-term outcomes with RFA over EA, although EA is still a reasonable first line consideration. RFA salvage after EA is possible and effective, especially for complex nodules with larger solid components.
期刊介绍:
Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.