대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제85권3호
  • /
  • Pages.618-630
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  • 2024
  • /
  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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낭성 및 고형성 혼합 갑상선 결절 치료에서 고주파 절제술 단독요법과 에탄올 절제 후 고주파 절제술 요법의 유효성 및 안전성 비교

The Comparison of Efficacy and Safety between Radiofrequency Ablation Alone and Ethanol Ablation Followed by Radiofrequency Ablation in the Treatment of Mixed Cystic and Solid Thyroid Nodule

  • 조민강 (가톨릭대학교 의과대학 여의도성모병원 영상의학과) ;
  • 이민경 (가톨릭대학교 의과대학 여의도성모병원 영상의학과) ;
  • 신재호 (가톨릭대학교 의과대학 성빈센트병원 영상의학과) ;
  • 서민국 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 정소령 (가톨릭대학교 의과대학 여의도성모병원 영상의학과)
  • Min Gang Jo (Department of Radiology, The Catholic University of Korea, Yeouido St. Mary's Hospital) ;
  • Min Kyoung Lee (Department of Radiology, The Catholic University of Korea, Yeouido St. Mary's Hospital) ;
  • Jae Ho Shin (Department of Radiology, The Catholic University of Korea, St. Vincent's Hospital) ;
  • Min Guk Seo (Department of Radiology, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • So Lyung Jung (Department of Radiology, The Catholic University of Korea, Yeouido St. Mary's Hospital)
  • 투고 : 2023.05.17
  • 심사 : 2023.08.10
  • 발행 : 2024.05.01
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초록

목적 본 연구는 낭성 및 고형성 혼합 갑상선 결절 치료에서 고주파 절제술 단독요법과 에탄올 절제 후 고주파 절제술 요법의 유효성 및 안전성을 비교하고자 하였다. 대상과 방법 본 연구는 초음파 유도 하 조직검사에서 양성으로 확인된 243개의 낭성 및 고형성 혼합 갑상선 결절을 대상으로 진행됐으며, 243개의 결절은 243명의 환자로부터 진단되었다. 연구 대상이 된 결절들은 고주파 절제술 단독요법과 에탄올 절제 후 고주파 절제술 요법을 받은 군의 두 군으로 나누어 분류됐다. 본 연구는 각 군에서의 시술 후 부피 감소율, 치료 성공률, 증상 및 미용 문제의 개선 정도를 평가하였다. 또한 시술 후 연관된 합병증이나 부작용이 발생하였는지 확인하였다. 결과 고주파 절제술 단독 요법 군에는 204명의 환자가 포함되었고, 에탄올 절제 후 고주파 절제술 요법 군에는 39명의 환자가 포함되었다. 단독요법군과 혼합요법 군에서 최종 추적 검사 시 평균 부피 감소율은 각각 81.6%와 87.2%였다. 두 군에서의 장기적 치료 성공률은 각각 90.2%와 97.4%였다. 치료 결과는 마지막 추적 관찰 시기에서 두 군에서 유사하게 나타났다. 대부분 낭성 결절에 국한된 추가 분석에서도 두 군 간에 치료 효과에 있어 유의미한 차이가 없었다. 증상 및 미용적 문제는 두 군에서 모두 현저하게 개선되었다. 시술 후 연관된 큰 합병증은 두 군 모두에서 발생하지 않았다. 결론 에탄올 절제 후 고주파 절제술 혼합 요법이 고주파 절제술 단독요법에 비해 약간 더 나은 치료 방법이지만, 두 치료 요법 모두 낭성 및 고형성 혼합 결절의 치료에 안전하고 효과적인 방법이다.

Purpose To compare the efficacy and safety of radiofrequency ablation (RFA) and ethanol ablation (EA) followed by RFA in treating mixed cystic and solid thyroid nodules. Materials and Methods We included 243 nodules from 243 patients who underwent RFA for mixed cystic and solid benign nodules. The nodules were divided into two groups (RFA alone and EA + RFA). We evaluated volume reduction rate (VRR), therapeutic success rate, improvement in symptomatic and cosmetic issues, complications, and adverse effects. Results The RFA group included 204 patients, and the EA + RFA group included 39 patients. The long-term success rates in the RFA only and EA + RFA groups were 90.2% and 97.4%, respectively. The mean VRR at the last follow-up in the RFA and EA + RFA groups were 81.6% and 87.2%, respectively. Therapeutic results were similar in both groups at the last followup. Cosmetic and symptomatic problems markedly improved in both groups. No major complications were observed. Conclusion Both RFA alone and EA + RA are safe and effective methods for treating mixed cystic and solid thyroid nodules, although EA + RFA is slightly more effective.

키워드

참고문헌

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