Percutaneous ethanol injection for benign cystic thyroid nodules: is aspiration of ethanol-mixed fluid advantageous?
OBJECTIVE
We evaluated the differences between percutaneous ethanol injection with and without aspiration of ethanol-mixed fluid for treatment of benign cystic thyroid nodules.


METHODS
We examined 60 patients with benign cystic thyroid nodules confirmed by fine-needle aspiration biopsy and divided them into 2 groups according to nonaspiration (group A, n = 30) or aspiration (group B, n = 30) of ethanol-mixed fluid after intracystic ethanol injection. We evaluated in both groups the complete disappearance of the cystic portion of the thyroid nodule on follow-up ultrasonography (first follow-up ultrasonography; mean, 4.6 months in group A; mean, 4.4 months in group B) (chi-square test), side effects or complications during and after the procedure (chi-square test), and the total procedure time (Student t test).


RESULTS
Most patients showed complete disappearance of the cystic portion of the thyroid nodule (group A, n = 29; group B, n = 28), and they revealed no recurrence on follow-up ultrasonography. There was no statistical difference in the success rates between group A and group B (P > .05). Pain, the most common side effect, and other mild side effects or complications occurred in small numbers of patients in each group, but there was no significant difference in side effects or complications between the 2 groups (P > .05), except for intracystic hemorrhage (P < .05) and the complaint of all group B patients due to a double puncture (P < .001). The total procedure time was nearly double in group B than in group A because of the additional procedures, such as complete evacuation of the ethanol-mixed fluid and the 10-minute compression.


CONCLUSIONS
Percutaneous ethanol injection without aspiration of ethanol-mixed fluid seems to be the preferable method of treatment of benign cystic thyroid nodules from the perspective of both the physician and the patient.
Kim
Dong Wook
DW
Department of Radiology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, South Korea.
Rho
Myung Ho
MH
Kim
Hak Jin
HJ
Kwon
Jae Su
JS
Sung
Young Sun
YS
Lee
Sang Wook
SW
D000328:Adult; D000368:Aged; D003560:Cysts / Q000000981:diagnostic imaging / Q000628:therapy*; D000431:Ethanol / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D013396:Suction / Q000009:adverse effects / Q000592:standards; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D014463:Ultrasonography
D000431:Ethanol