Treatment of cystic thyroid nodules

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Techniques in Vascular and Interventional Radiology Pub Date : 2022-06-01 DOI:10.1016/j.tvir.2022.100822
Kepal N. Patel MD , Catherine Sinclair MD
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引用次数: 1

Abstract

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.

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囊性甲状腺结节的治疗
囊性甲状腺病变的最佳治疗方案取决于病变的组成、先前的干预措施和患者的偏好。单纯抽吸对于主要为囊性甲状腺病变是一种良好的初始诊断和治疗方式。然而,复发率很高,如果液体重新积聚,进一步的愿望不太可能有效。乙醇消融是一种很好的一线治疗方法,因为它相对安全、耐受性好、操作简单。对于单纯性囊肿和具有实性成分的复杂甲状腺囊肿,它至少与射频消融术(RFA)一样有效,如果不是更有效的话。EA的疗效与任何给定病变内固体成分的百分比呈负相关。有证据表明,含20%实性成分的复杂囊肿,RFA治疗的远期疗效优于EA治疗,尽管EA仍是合理的首选治疗方法。EA术后RFA抢救是可能和有效的,特别是对于具有较大固体成分的复杂结节。
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来源期刊
Techniques in Vascular and Interventional Radiology
Techniques in Vascular and Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.70
自引率
0.00%
发文量
47
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.
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