Sonographically Guided Ethanol Sclerotherapy for Benign Thyroid  Cysts

Cho, Yong Soo; Lee, Ho Kyu; Ahn, Il Min; Lim, Soo Mee; Kim, Dae Hong; Choi, Choong Gon; Suh, Dae Chul

doi:10.2214/ajr.174.1.1740213

Cited by 95 publications

(82 citation statements)

References 24 publications

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“…The numbers of PEI procedures were not different in both subgroups. Cho et al reported no difference in VRRs between pure and complex cysts 5 . For cysts containing thick, viscous fluid, two-step ethanol ablation may be used.…”

Section: Discussionmentioning

confidence: 95%

“…In our group, the non-aspiration approach was used more frequently, both because less ethanol was applied and because the procedure was shorter and another injection was not needed to aspirate ethanol. The reported success rates range from 68% in a study by Cho et al to 100% in a study by Sung et al 5,15 . In our group, the success rates were identical for both small and medium-sized cysts.…”

Section: Discussionmentioning

confidence: 96%

“…Complex cysts are defined as cystically degenerated nodules with the cystic component accounting for more than 60% of the nodule volume 4 . Primary cysts account for approximately 1% of nodules 5,6 . Thyroid cysts with a volume of 5 mL or more may cause mechanical problems and especially cosmetic defects.…”

Section: Introductionmentioning

confidence: 99%

“…The mechanism of action of ethanol is based on coagulative necrosis, reactive fibrosis and small vessel thrombosis. Therapeutically successful is a reduction in cyst volume of more than 50% or complete disappearance of the fluid component and no recurrence of the cyst 5,8 . Presented here is our experience with US-guided PEI treatment of small and medium-sized cysts using relatively small amounts of 96% ethanol.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-guided percutaneous ethanol injection of small and medium-sized thyroid cysts with relatively small amounts of ethanol

Halenka

Karásek

Fryšák

2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. Ultrasound-guided percutaneous ethanol injection (US-guided PEI) is used in patients with recurring symptomatic thyroid cysts in whom simple drainage was not successful. It is an alternative non-surgical approach in patients refusing or at risk during surgery. Methods and Results. US-guided PEI was performed in 33 patients, with a success rate of 100% and significantly decreased cyst volume after 1, 3 and 6 months after the last PEI compared with the initial volume. The mean number of PEI procedures was 1.5±0.7 with a mean 96% ethanol volume of 2.4±1.2 mL. In the entire group, the initial cyst volume was significantly reduced to the final volume at 6 months after PEI (10.82±5.03 mL vs. 0.78±0.84 mL; P<0.001). Also in all patients, mean volume reduction rates were significantly increased (P<0.001) at check-ups at 1 month (83.1±8.1%), 3 months (89.9±6.3%) and 6 months (92.6±6.4%). In case of medium-sized cysts, more PEI procedures were needed than in small cysts (1.1±0.4 vs. 2.0±0.5). The total amount of 96% ethanol was equal to 22.7±7.9% of the initial cyst volume. Conclusion. Our experiences confirm that small and medium-sized cysts may be successfully treated with relatively small amounts of ethanol. In case of medium-sized cysts, more PEI procedures were needed. Final reduction of complex cysts was achieved later. Apart from temporary localized pain, no serious complications were observed in most cases.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound-guided percutaneous ethanol injection of small and medium-sized thyroid cysts with relatively small amounts of ethanol

Halenka

Karásek

Fryšák

2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…2 In patients with cosmetic or symptomatic problems, the initial procedure is the simple aspiration of the cystic portion; this reduces the cyst volume and aids in specific diagnosis, but it is associated with a high recurrence rate of up to 80%. 3,4 For recurrent cases after aspiration, ethanol ablation (EA) has been attempted with good results. 5,6 Recently, radiofrequency (RF) ablation has been used to treat benign thyroid nodules with a low complication rate, [7][8][9][10][11][12] including thyroid nodules with a cystic portion 6,8 and recurrent thyroid cancers.…”

mentioning

confidence: 99%

Combination Therapy Consisting of Ethanol and Radiofrequency Ablation for Predominantly Cystic Thyroid Nodules

Yoon

Baek

Lee

et al. 2013

AJNR Am J Neuroradiol

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SUMMARY:Predominantly cystic thyroid nodules are often aspirated before radiofrequency ablation to enhance its efficacy; however internal bleeding during the aspiration is a problem. We evaluated the feasibility and safety of ethanol ablation to control internal bleeding that occurred during preparatory aspiration. Between September 2010 and August 2011, 11 of 40 predominantly cystic nodules bled internally during fluid aspiration before radiofrequency ablation. To control the bleeding, 99% ethanol was injected. The efficacy of ethanol in controlling bleeding, final nodule volume and complications were assessed. Control of the bleeding by ethanol ablation and subsequent radiofrequency ablation was feasible in all patients. Ninety-one percent (10/11) could be treated in 1 session. The mean nodule volume dropped from 17.1 to 4.3 mL (P Ͻ .018). There were no major complications. Ethanol ablation and radiofrequency ablation combination therapy is a feasible and safe technique for treating predominantly cystic thyroid nodules that exhibit internal bleeding during preparatory aspiration. ABBREVIATIONS:EA ϭ ethanol ablation; RF ϭ radio-frequency; US ϭ ultrasound

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Sonographically guided percutaneous ethanol treatment of a symptomatic complex nodule with a large cystic component in a patient with thyroid hemiagenesis

Braga‐Basaria

Basaria

Mesa

et al. 2002

J of Clinical Ultrasound

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Thyroid hemiagenesis is a rare anomaly that is usually discovered incidentally during the evaluation of unrelated thyroid disorders. We present the case of a patient with hemiagenesis of the left thyroid lobe and a large, recurrent, symptomatic complex nodule with a large cystic component that occupied most of the right lobe. She had previously undergone multiple unsuccessful aspirations of the cyst. The patient was successfully treated with an intranodular injection of ethanol under sonographic guidance. The success of this procedure resulted in the resolution of symptoms and avoidance of surgical resection of the right lobe, with resulting hypothyroidism. We recommend that ethanol injections be considered for treatment of symptomatic cystic or benign solid nodules in patients with thyroid hemiagenesis and in those who have undergone hemithyroidectomy and have symptomatic nodules.

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Sonographically Guided Ethanol Sclerotherapy for Benign Thyroid Cysts

Abstract: Sonographically guided ethanol sclerotherapy is a safe and effective tool for the therapy of benign thyroid cysts.

Cited by 95 publications

References 24 publications

Ultrasound-guided percutaneous ethanol injection of small and medium-sized thyroid cysts with relatively small amounts of ethanol

Ultrasound-guided percutaneous ethanol injection of small and medium-sized thyroid cysts with relatively small amounts of ethanol

Combination Therapy Consisting of Ethanol and Radiofrequency Ablation for Predominantly Cystic Thyroid Nodules

Sonographically guided percutaneous ethanol treatment of a symptomatic complex nodule with a large cystic component in a patient with thyroid hemiagenesis

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