探讨甲状腺囊实性结节射频和微波消融的可行性及效能。

使用目前常用的热消融方式（射频和微波）对甲状腺囊实性结节囊性成分的模拟液体（蒸馏水、生理盐水、血液、肝囊肿穿刺液和甲状腺囊实性结节穿刺液）进行消融。作用功率为目前临床常用的热消融功率（35 W和50 W），每30 s记录温度值，连续监测10 min，绘制时间温度曲线。观察消融针针尖情况，记录针尖液体固化大小、形态及内部结构特点，必要时送病理检查。比较相同功率消融达到目标温度（60 ℃）的时间，并使用方差分析比较相同功率的射频和微波消融的热效能差异。

蒸馏水仅能进行微波消融，而无法进行射频消融。35 W射频消融在生理盐水、肝囊肿穿刺液中比微波消融较早达到消融目标温度［（171.4±3.9）s vs（343.6±5.7）s、（170.2±4.8）s vs（444.5±7.2）s］，时间温度曲线上具有较好的热效能（F=228.311、193.632，P均＜0.001）；50 W射频消融在肝囊肿穿刺液中比微波消融较早达到消融目标温度［（127.3±3.1）s vs（165.7±3.4）s］，时间温度曲线上具有较好的热效能（F=47.429，P＜0.001）；但射频消融在血液和甲状腺囊实性结节穿刺液中无法达到消融目标温度。而50 W微波消融能在所有模拟液体中达到消融目标温度，且在血液和甲状腺囊实性结节穿刺液中的热效能明显优于射频消融（F=47.429、22.859，P均＜0.001）。

微波消融能对各甲状腺囊实性结节囊性成分的模拟液体进行消融，且性能相对稳定。射频消融热效能较高，但对蒸馏水无法消融，对血液和甲状腺囊实性结节穿刺液因针尖容易形成积碳而效果不佳。

To evaluate the feasibility of ablating the cystic component of cystic-solid nodules of the thyroid (CSNT) using radiofrequency ablation (RFA) and microwave ablation (MWA) in vitro.

The fluid simulation of CSNT cystic components in the body, like distilled water, normal saline, blood, puncture fluid of liver cyst, and the puncture fluid of CSNT, were ablated with the currently commonly used thermal ablation instruments. RFA and MWA were utilized in this study, and the ablation output power was 35 W and 50 W, respectively, which were commonly used in clinical practice. The temperature value was recorded every 30 seconds, and continuously for 10 minutes. The time temperature curve (TTC) was drawn for every test. The tip of the ablation needle was observed after the ablation, and the size, shape, and internal structure of the solidification around the needle tip were recorded. Pathological examination of the solidification around the needle tip was performed if necessary. The time of RFA and MWA to reach the target temperature (60 ℃) with the same power was compared, and the TTC was analyzed by variance analysis.

Distilled water can only be ablated by MWA, but not by RFA. The target temperature of RFA in normal saline and liver cyst puncture fluid was reached earlier than that of MWA [(171.4±3.9) s vs (343.6±5.7) s, F=228.311, P＜0.001; (170.2±4.8) s vs (444.5±7.2) s, F=193.632, P＜0.001] at the output power of 35 W, while at the power of 50 W, MWA had better thermal efficiency in TTC [(127.3±3.1) s vs (165.7±3.4) s, F=47.429, P＜0.001). In contrast, the target temperature in blood and the fluid punctured from CSNT was not reached. MWA at 50 W achieved the target ablation temperature in all the simulated liquids, and the thermal efficiency in blood and the fluid punctured from CSNT were obviously better than that of RFA (F=47.429 and 22.859, both P＜0.001).

MWA can be used to ablate the simulated fluid of CSNT, and the performance is relatively stable. RFA has a high thermal efficiency, but it fails to ablate distilled water. RFA has a poor effect on blood and the fluid punctured from CSNT because the tip of the needle is easy to form carbon deposit.