Treatment of autonomous and toxic thyroid adenomas by percutaneous ultrasound-guided ethanol injection.
OBJECTIVE
To evaluate the feasibility and efficacy of US-guided percutaneous ethanol injection (PEI) in the treatment of autonomous and toxic thyroid adenomas.


METHODS
PEI was performed in 42 patients with solitary, scintigraphically "hot" nodules (n=37) or toxic nodular goiter (n=5). The nodular volume ranged from 2.5 to 38 cm3 (mean volume, 20.7+/-14.1 cm3). Ethanol was injected using a free-hand technique, usually in multiple sessions, using color and power Doppler US guidance. Treatment success was evaluated following 3-4 months after PEI by scintigraphy, hormonal status, and US findings.


RESULTS
The procedure was technically successful in 39 patients (93%). Three patients were lost to follow-up. Minor complications were pain (all patients), subcutaneous hematoma (n=6), and transitory dysphonia (n=1). A complete cure was achieved in 22 patients (52%), and a partial cure in 10 patients (24%). In 4 cases (9%), the result was unsatisfactory since only moderate hormonal remission was observed. A satisfactory results was thus achieved in 32/42 patients (76%). Significant nodular volume reduction was observed in all cases. Better results were observed in smaller nodules and in cases of autonomous adenomas. There were no cases of recurrent hyperthyreosis.


CONCLUSIONS
US-guided PEI is an efficient and safe method in the treatment of autonomous thyroid nodules and it enables inactivation of nodules with minimal or transitory complications.
Brkljacic
B
B
Department of Radiology, University Hospital Merkur, Zagreb, Croatia.
Sucic
M
M
Bozikov
V
V
Hauser
M
M
Hebrang
A
A
D000236:Adenoma / Q000000981:diagnostic imaging / Q000628:therapy*; D000328:Adult; D000368:Aged; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006044:Goiter, Nodular / Q000628:therapy; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
D000431:Ethanol