Ultrasonography-guided Percutaneous Ethanol Injection (PEI) For Treatment Of Thyroid Cystic Nodule

Background and Objective:Ultrasonography-guided percutaneous ethanol injection (PEI) treatment is a new way for thyroid nodules, except for surgery resection, drug and radioiodine therapy. Coagulative necrosis and microvascular embolization is considered to be the histological basis in the target area by ethanol injection. Traditional surgical treatment for thyroid cystic nodules(TCNs) is always thought to be expensive and painful with complication. Purpose of this research is to evaluate the clinical curative effects and syndromes of Ultrasonography-guided PEI therapy for TCNs and discuss the practical details.Materials and Methods: 24 patients (7 male and 17 female) aged 45 + 4.2 years with TCNs confirmed to be benign initially by ultrasonography-guided fine-needle aspiration biopsy(FNAB) or contrast sonography were treated by ultrasonography-guided PEI. These nodules include 6 simple cysts (SC) and 18 complicated cysts(CC), the pretreatment nodule volume were 10. 33 + 1. 08ml and8.14 + 1. 89ml respectively. Before and after PEI 10 days, 30 days, 60 days, 90 days, these cystic nodules were observed by ATL HDI5000 with the sonographic contrast imaging, SonoCT, 3D imaging and etc. The doses of 99% ethanol with 0. 5 to 1. 5 times the base volume of thyroid cyst were injected into cysts with 18-20 gauge needle by ultrasound guidance. The volume and the area of liquid in the maximum long axis view (MLAV) of cystic nodules can be get from two dimensional ultrasound (2DUS). Additionally, The changes of thyroid cystic nodules after PEI can be observed by three dimensional (3D) reconstruction with SonoCT . The clinical curative effect of PEI therapy is mainly judged by the extent of volume reduction. Reduction greater than 50% TCN base volume is classified as effective response(ER), reduction more than 90% is significant response (SR), reduction less than 50% is classified as no change (NC). Statistical analysis: All data were analyzed with SPSS 11.0 by paired T-test, Chi-square test and correlation test. Result1. The volume of the TCNs decreased markedly. The mean reduction rate (RR) of volume were 88.23 + 4. 18% in SC and 81.7 ±4. 68% in CC; the efficacy rate was 100% in SC and 83. 33% in CC. Significant difference was found in SR between SC(100%) and CC(44. 44%).2. In 60 days after PEI, thyroid cystic nodules shrinked rapidly or disappeared . The volume reduction rate of TCNs under PEI is corrected with the volume of liquid extracted and ethanol injected (P<0. 05), no significant correlation was found between the...