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PEI should be performed by a well trained physician
under sonographic guidance using a 21–23
gauge needle. A prerequisite for PEI treatment
must be a benign cytology of the thyroid nodule;
in addition, the thyroid lesion to be treated with
ethanol should have a complete and intact capsule.
Solid (”hot” or ”cold”) nodules can be
injected with 0.5–1 ml 95 % ethanol per ml of
nodule volume; in the case of cystic lesions, fluid
is first removed before 3–5 ml ethanol is injected.
At sonography, ethanol is visualized during injection
as an inhomogeneous round hyperechoic
area, which is rapidly replaced by many scattered
hyperechoic spots indicating ethanol deposition
within the thyroid tissue (Fig. 1). PEI is administered
once or twice weekly and treatment is usually
completed in 3–4 sessions, depending on the
size of solid nodules.
Figure 1:
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During
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| Figure 1. Ultrasound image of ethanol injection
into a toxic thyroid nodule. Arrows point to the nodule. |
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