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Objective To analyze the CT features of solitary pulmonary nodules(SPN) in patients with malignant tumor with the aim of improving its diagnosis and differential diagnosis in this special background .Methods From May 2014 to De-cember 2018, the CT data of 76 pathologically confirmed SPNs in patients with malignant tumor were retrospectively analyzed . The CT features of SPNs, including density, morphology and change of peripheral lung field and adjacent structures, were mainly analyzed.The characteristics of different types of nodules and their differences were summarized .Results Among the 76 SPNs, there were 41(53.9％) primary lung cancers, 14(18.5％) metastatic tumors, and 21(27.6％) benign lesions(in-cluding 12 inflammatory nodules, 7 tuberculous nodules and 2 benign tumors).Of all nodules, there were 57(75％) solid nodules, including 23(40.4％) primary lung cancers which mainly manifested as nodules with rough margin , close to adjacent vessel and bronchus and usually had internal or edge features(19, 82.6％), 14(24.6％) metastatic tumors which mainly showed as round or oval, homogeneous density, smooth margin nodules(12, 85.7％), and 18(31.6％) inflammatory nodules which mainly showed as lesions with rough and blurred margin accompanied by peripheral patch or fibrosis (14, 77.8％). There were 19(25％) sub-solid nodules, including 18(94.7％) primary lung cancers, which mainly manifested as nodules with heterogeneous density and clear border(14, 77.8％).There was only 1(5.3％) sub-solid inflammatory nodule.Conclu-sion The pathological nature of SPNs in patients with malignant tumors is various .Understanding their CT characteristics is helpful for diagnosing and differentiating and providing useful information for further treatment .
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Objective To evaluate the effectiveness ,safety and prospect of ultrasound-guided radiofrequency ablation (RFA) in treatment of thyroid benign nodules .Methods We analyzed 153 patients with thyroid benign nodules from September 2015 to August 2016 treated by RFA at Department of Thyroid Surgery ,the First Affiliated Hospital of Zhengzhou University . One month later , we reviewed the thyroid functions after the operation , observed the changes of the nodules after 1 ,3 ,and 6 months ,calculated the volume reduction rate of the nodules , and analyzed the effectiveness of the treatment .Results After treatment ,the maximum diameter and volume of the nodules were significantly reduced in all the patients ( P<0 .05) .The patients' symptoms improved significantly without serious complications . Conclusion Ultrasound-guided RFA has obvious advantages such as fewer complications , less invasiveness , good safety , and definite effectiveness in treating thyroid benign nodules . Therefore ,it has promising prospects in clinical application .
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Objective:To assess the clinical value of ultrasonic imaging in combination with McGill thyroid nodules score (MTNS) system in differential diagnosis of nodule size and benign and malignant tumors.Methods: The clinical data of a total of 112 patients with thyroid nodules were analyzed retrospectively. The nidus of the patients was identified by ultrasound-guided fine needle aspiration biopsy, and then the MTNS, nodule size and false negative rate of the patients were calculated, respectively.Results: The MTNS of the 112 cases of patients with thyroid nodules was within the range of 1 to 18, with an average score of (6.83±2.31). 16 cases with malignant nodules(the percent was 14.29%) were finally diagnosed by pathology, and 96 cases were diagnosed with benign nodules(the percent was 85.71%). The MTNS of patients with malignant nodules was significantly higher than that of those with benign nodules. Ultrasonic imaging showed that the nodule diameter was within the range of 1 to 8.9cm, with an average diameter of (4.13±4.13)cm. MTNS was positively correlation with nodule diameter (r=0.146,P<0.05). Besides, the average diameter of benign nodules was (3.67±1.60)cm, and that of malignant nodules was (4.23±1.51)cm. The missed diagnosed malignant nodules mainly were large diameter nodules.Conclusion: Ultrasound imaging in combination with MTNS can better predict the benign or malignant risk of thyroid nodules.
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Objective To evaluate therapeutic effects of radiofrequency ablation for thyroid benign nodules . Methods By using the radiofrequency electrode (18G ×7 cm, working segment length =1 cm), a total of 61 patients with 87 thyroid benign nodules underwent ultrasound-guided radiofrequency ablation in our department from February 2013 to May 2014.The maximum diameter , volume, and volume-reduction ratio (VRR) were measured by ultrasound at 1, 3, 6, and 12 months after operation. Results The 61 patients with 87 thyroid benign nodules were successfully treated with radiofrequency ablation , including 3 cases receiving secondary ablation after 1 month.The maximum diameter of thyroid nodules was (2.24 ±0.63) cm preoperatively, and (1.82 ±0.81) cm, (1.52 ±0.72) cm, (1.03 ±0.43) cm, and (0.56 ±0.36) cm at 1, 3, 6, and 12 months after ablation, respectively.The maximun volume was (5.37 ±1.85) ml preoperatively, and (4.41 ±2.16) ml, (3.19 ±1.92) ml, (1.34 ±0.61) ml, and (0.69 ±0.41) ml at 1, 3, 6, and 12 months after ablation, respectively.The VRR were (20.7 ±13.2)%, (48.6 ±16.1)%, (77.3 ±4.7)%and (88.7 ±5.6)%, respectively at 1,3,6, and 12 months after ablation.At the final follow-up, 51 (58.6%) nodules disappeared completely. Conclusion Ultrasound guided radiofrequency ablation for thyroid benign nodules is safe and effective .
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Objective To explore the feasibility and efficacy of endoscopic-assisted thyroidectomy (EAT) in the treatment of benign thyroid nodules.Methods Sixty-five patients with one-side benign thyroid nodules were treated with EAT (EAT group,n =33) or conventional open thyroidectomy(control group,n =32) from Jan.To Dec.2013.The operation time,blood loss amount,volume of drainage,visual analog scores (VAS) for pain severity,occurrence of postoperative complications,evaluation of cosmetic,and hospital expense were recorded.Results The operation were performed successfully in patients of two groups.Blood loss volume was significantly less in EAT group (26.7 ± 23.1) ml than in control group ((45.2-± 28.9) ml,t =2.85,P ＜0.05).The volume of drainage in EAT group was (31.4 ± 8.1) ml,less than that in control group((83.6 ± 17.3) ml,t =15.66,P ＜ 0.05).The VAS at the day of 1 st,3rd after operation were (1.5-± 0.4) and (1.0 ±0.2) in EAT group was significantly lower than those in control group ((2.2 ±0.5) and (1.5 ±0.3) ;t =6.01,7.29;P ＜0.05).Satisfaction rate of cosmetic in EAT group was higher than control group (97.0％ vs 68.8％,x2 =9.02,P ＜ 0.05).Conclusion EAT is proved with safe and feasible in the treatment of benign thyroid nodules,which is with the advantage of minimally invasive and cosmetic results.