برري تاثير تزريق داخل گره اي اتانول 96 در درمان گره هاي سرد منفرد خوش خيم مقاوم به سركوب بالووتيرو كسين

Effectiveness of percutaneous ethanol injection in benign single cold thyroid nodule unresponsive to levothyroxin suppression therapy

Introduction: The result of studies using suppression dose of L-T4 on solid benign cold thyroid nodule have been conflicting; percutaneous ethanol injection(PEI) into cold nodules has been proposed as an alternative treatment. The aim of this study was to evaluate the effect of this therapy and the result of ethanol injection on different cytologic benign thyroid nodules. Materials and Methods: The study population consisted of 50 patients with benign cold thyroid nodules, that had been unresponsive to suppressive levothyroxin therapy for 6 months. These nodules were injected with PEI, intra-nodularly, three times. Thyroid nodule volumes were assessed by high resolution ultrasongraphy before and after ethanol injection, and the relation between nodular size reduction, clinical parameter,and cytopathologic features was determined. Results: Mean pretreatment nodule volume was 20. 83 mL±8.37 (range 4-46cc) and 3 months after ethanol injection, it was 12. 88±8. 7 mL, P(0/001). Appropriate response (50% or more) was observed in 36% of patients and neither clinical parameter nor pretreatment cytopathologic features or size of nodule were related to nodular volume reduction. Conclusion: Our data suggest that PEI is an appropriate treatment for thyroid nodules, unresponsive to suppressive levothyroxin therapy. Nodule reduction is independent of cytopathologic features or pretreatment nodular size.