Ultrasound-guided LASER ablation of thyroid nodules

Purpose: To define of efficacy of a laser ablation of subcentimetric thyroid nodules. Material and methods: 130 patients (age – 43.9+15.1 years) with nodular goiter in the sizes less than 1 cm (infracentimetric nodules was treated. Laser ablation (power 3.5 W) was performed with ultrasound guidance (Medison Pico, linear 7.5 – 15 MHz probes) of conducting a 0.4 mm optical fiber. Control US studies are performed on 1, 3, 6 and more months after destruction. US studied change of the sizes, volume, echoic, echostructure, vascularity of nodules. Results: Positive effects of laser destruction in treatment of infrabcentimetric thyroid nodules was achieved in most cases. US criteria for destruction efficacy are as follows: nodule size reduction more than 50%, nodule fragmentation, change in echostructure, indistinct margins, hypo- or avascularity in CDI. In 107 cases (90%) infracentimetric nodules have decreased in volume, including at 19 cases (14.6%) disappearance of focuses. The relative quantity hypoechoic (> 0.05), isoechoic (p < 0.01), anecogenic (p < 0.01) nodules has decreased, hyperechoic nodules (p < 0.01) was enlarged. As a result of destruction the blood stream has not been defined in 55.9% of nodules and has been considerably relaxed in 41.4%. Appearance of hyperechoic focuses (12.6%) and points of calcination (8.1%) was noted. In most cases (83.8%) nodules had indistinct borders. Conclusion: Results of laser destruction at patients with thyroid nodules less than 10 mm in diameter authentically are better, than at focuses of the larger sizes (χ2 = 6.218, p < 0.05). That allows to recommend laser destruction at treatment of small thyroid nodules.