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Abstract：
Standard therapeutic approaches for benign thyroid lesions that warrant intervention are surgery for cold and either surgery or radioiodine for autonomously functioning thyroid nodules (AFTN). Image-guided thermal ablation (TA) procedures are increasingly proposed as therapy options for selected clinical conditions. Due to mounting scientific evidence and widening availability, ETA considered it appropriate to develop guidelines for the use of TA in adult patients. TA procedures are well tolerated, but a dedicated training of the operators is required and information on possible complications needs to be shared with the patients. The following factors should be considered when weighing between observation, surgery, and TA for benign thyroid nodules. In solid non-hyperfunctioning nodules, TA induces a decrease in thyroid nodule volume, paralleled by improvement in symptoms. Nodule re-growth is possible over time and may necessitate repeat treatment, or surgery, in a dialogue with the patient. In AFTN, radioactive iodine is the first-line treatment, but TA may be considered in young patients with small AFTN due to higher probability of restoring normal thyroid function and avoidance of irradiation. In cystic nodules, ethanol ablation (EA) is the most effective and least expensive treatment. TA may be considered for cystic lesions that relapse after EA or have a significant residual solid component following drainage and EA. TA should be restricted to benign lesions that cause symptoms or cosmetic concern. Presently, laser and radiofrequency ablation are the most thoroughly assessed techniques, with similar satisfactory clinical results. Microwaves and high-intensity focused ultrasound therapy options remain to be fully evaluated.
摘要：
需要干预的良性甲状腺病变的标准治疗方法是冷手术和手术或放射性碘治疗自主功能甲状腺结节（AFTN）。图像引导热消融（TA）程序越来越多地提出作为选定临床条件的治疗选择。由于越来越多的科学证据和不断扩大的可用性，ETA认为制定成人患者使用TA的指南是适当的。TA程序耐受性良好，但是需要对操作人员进行专门的培训，并且需要与患者分享有关可能的并发症的信息。在观察之间权衡时应考虑以下因素，手术,和甲状腺良性结节的TA。在固体非功能亢进结节中，TA诱导甲状腺结节体积减少，伴随着症状的改善。随着时间的推移，结节可能会重新生长，并且可能需要重复治疗，或者手术，与病人对话。在AFTN,放射性碘是一线治疗，但在AFTN较小的年轻患者中，由于其恢复正常甲状腺功能和避免照射的可能性较高，因此可以考虑TA。在囊性结节中，乙醇消融（EA）是最有效和最便宜的治疗方法。对于EA后复发或引流和EA后残留大量固体成分的囊性病变，可以考虑TA。TA应仅限于引起症状或美容问题的良性病变。目前,激光和射频消融是评估最彻底的技术，具有相似满意的临床效果。微波和高强度聚焦超声治疗方案仍有待充分评估。
