比较超声引导下经皮射频消融（RFA）与手术切除（SR）治疗危险三角区甲状腺乳头状癌（PTC）的安全性和有效性。298例接受经皮射频消融（RFA）或手术切除（SR）治疗PTC的患者的临床资料对2018年1月至2020年4月我院甲状腺危险三角区的病例进行回顾性分析。采用倾向评分匹配来调节混杂因素。所有接受消融的患者均采用将足够的气管旁液体隔离与低功率短电极相结合的策略进行治疗。采用 Kaplan-Meier 曲线对 T1N0M0 PTC（T1a 和 T1b）患者的疾病进展进行分析。记录并比较治疗参数以及局部复发率、远处转移和并发症的发生率。在纳入的 182 名符合条件的患者中，91 名患者接受 RFA（年龄 44.84 ± 13.19 岁；71 名女性；77 名 T1a），91 名患者接受 SR （年龄 47.36 ± 11.05；68 名女性；69 名 T1a）。 RFA 的平均治疗时间、住院时间、失血量和疤痕长度明显少于 SR。主要并发症以及术后永久性喉返神经损伤和术后短暂性甲状旁腺功能障碍仅发生在SR组，两组之间有显着差异（p<0.05）。 RFA与SR治疗T1N0M0 PTC的疾病进展无本质区别。RFA短期内与危险三角区PTC的手术效果相同，恢复更快，并发症更少。射频消融的临床疗效与短期内手术治疗危险三角区甲状腺乳头状癌，与手术相比具有恢复快、并发症少的优点。在甲状腺危险三角区采用射频消融（RFA）目前仍存在争议。 RFA 组和手术组在疾病进展方面没有差异，并且 RFA 没有发生重大并发症。射频消融为处于危险三角的甲状腺乳头状癌患者提供了一种新的选择。© 2024。作者，获得欧洲放射学会的独家许可。

To compare the safety and efficiency of ultrasound-guided percutaneous radiofrequency ablation (RFA) and surgical resection (SR) for thyroid papillary carcinoma (PTC) in the danger triangle area.The clinical data of 298 patients who underwent either percutaneous RFA or SR for PTC in the thyroid danger triangle at our hospital between January 2018 and April 2020 were retrospectively analyzed. Propensity score matching is employed to regulate for confounding factors. All patients undergoing ablation were treated using a strategy that combined sufficient paratracheal fluid isolation with a low-power, short electrode. Disease progression was analyzed in patients with T1N0M0 PTC (T1a and T1b) employed in Kaplan‒Meier curves. Treatment parameters and the rates of local recurrence, distant metastasis, and complications are recorded and compared.Of 182 eligible patients who were included, 91 were in the RFA (age 44.84 ± 13.19; 71 females; 77 T1a) and 91 were in the SR (age 47.36 ± 11.05; 68 females; 69 T1a). The average treatment time, length of hospital stays, blood loss volume, and scar length are substantially less in the RFA than in the SR. Major complications as well as postoperative permanent recurrent laryngeal nerve injury and postoperative transient parathyroid dysfunction occurred only in the SR, with a substantial distinction between the two groups (p < 0.05). There is no substantial distinction in the disease progression between RFA and SR treatment of T1N0M0 PTC.RFA is as effective as surgery for PTC in the danger triangle area in the short term, with faster recovery and fewer complications.Radiofrequency ablation has a clinical efficacy comparable to surgery in the treatment of papillary thyroid carcinoma in the danger triangle area in the short term with the advantages of faster recovery and fewer complications when compared with surgery.Use of radiofrequency ablation (RFA) in the thyroid danger triangle is still controversial. RFA and surgery groups showed no difference in disease progressions, and no major complications occurred with RFA. Radiofrequency ablation offers a new option for papillary thyroid carcinoma patients in the danger triangle.© 2024. The Author(s), under exclusive licence to European Society of Radiology.