Journal of Ultrasound in Medicine, Vol 19, Issue 1 39-46, Copyright © 2000 by American Institute of Ultrasound in Medicine
Power Doppler ultrasonographic assistance in percutaneous ethanol injection of autonomously functioning thyroid nodules
S. Spiezia, G. Cerbone, A. P. Assanti, A. Colao, M. Siciliani and G. Lombardi
Surgery Department, Incurabili Hospital, Naples, Italy.
The purpose of this study was to explore the potential role of power
Doppler sonography in guiding percutaneous ethanol injection of
autonomously functioning thyroid nodules. Thirty-two patients with pretoxic
adenoma and 15 with toxic adenoma underwent percutaneous ethanol injection
under power Doppler sonographic guidance. All patients with pretoxic
adenoma and 13 of 15 patients with toxic adenoma were treated successfully
(normalization of circulating thyroid hormones and thyroid stimulating
hormone levels and disappearance of nodular hyperactivity with complete
recovery of extranodular tracer uptake at scintigraphy). Power Doppler
sonography showed the progressive reduction of the intranodular blood flow
until its extinction after 6 to 12 months. Nodular shrinkage was obtained
in all patients (from 10.85 +/-1.04 to 2.9 +/- 0.3 ml in pretoxic adenoma
and from 15.4 +/- 1.8 to 4.2 +/- 0.7 ml in toxic adenoma. Power Doppler
sonographic guidance seems to improve the outcome of percutaneous ethanol
injection, allowing detection of blood flow even in very small vessels,
permitting the ethanol to be guided toward the main afferent vessels of the
nodules, and making it possible to monitor the diffusion and the effects of
ethanol on nodular vascularization.
