[Long-term results of ultrasound-guided ethanol injections in patients with autonomous thyroid nodules and hyperthyroidism].
OBJECTIVE
The aim of this study was to evaluate the long-term efficacy of treatment of autonomous thyroid nodules with percutaneous ethanol injection under ultrasound guidance.


METHODS
In a period of 56 months, 20 patients (13 women and seven men, mean age 67.5 +/- 12.3 years) with autonomous toxic thyroid nodules were treated with percutaneous ethanol injection under ultrasound guidance. Ethanol was injected percutaneously on an outpatient basis for a mean of 2.85 +/- 1.1 injections per patient, mainly depending on the nodule's size. The mean volume of injected ethanol was 4.63 ml. The median follow-up time was 763 +/- 452 days.


RESULTS
The injection was well tolerated by the patients, a mild to moderate local pain occurred in 21% of sessions. Undesirable effects were not serious and only transient and receded. Major complications like transient dysphonia or common jugular vein thrombosis have not been observed. After a mean time of 50 +/- 23 days an euthyroid state with normalized basal levels of TSH, fT3 and fT4 was maintained in 16 patients (80%), while four patients (20%) did not completely respond to the treatment. In this patients a therapy with methimazole was carried out. The rate of reduction in the nodular volume was 60.8%.


CONCLUSIONS
The percutaneous ethanol injection appears to be an effective, harmless and low-cost alternative treatment of autonomous thyroid nodules, especially in older and multimorbid patients.
Janowitz
P
P
Klinik für innere Medizin, Krankenhaus Burg, Akademisches Lehrkrankenhaus der Otto-von-Guericke-Universität Magdeburg. p.janowitz@kreiskrankenhaus-burg.de
Ackmann
S
S
D000236:Adenoma / Q000188:drug therapy* / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D000431:Ethanol / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D005858:Germany; D006801:Humans; D006980:Hyperthyroidism / Q000191:economics / Q000209:etiology*; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography
D000431:Ethanol