Doppman J L, Oldfield E H, Heiss J D
Department of Diagnostic Radiology, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bldg 10, Rm 1C660, Bethesda, MD 20892-1182, USA.
Radiology. 2000 Feb;214(2):341-8. doi: 10.1148/radiology.214.2.r00fe46341.
To describe the technique and results of injecting ethanol directly into symptomatic vertebral hemangiomas.
Eleven patients with paraplegia (n = 6) or radiculopathy (n = 5) due to vertebral hemangioma were treated by means of injecting ethanol (5-50 mL) directly into the lesion with computed tomographic (CT) guidance. CT angiograms were essential prior to treatment to identify functional vascular spaces of the hemangioma and direct needle placement.
All hemangiomas were obliterated completely at follow-up angiography and gadolinium-enhanced magnetic resonance imaging. Five of six patients with paraplegia recovered completely: One who was treated recently was walking with assistance. Four of five patients with radiculopathy improved. No immediate complications were associated with ethanol injection. The two patients who received the largest volumes of ethanol, 42 and 50 mL, developed pathologic fractures of the involved vertebrae 4 and 16 weeks after treatment.
Direct injection of ethanol into symptomatic vertebral hemangioma is an effective and safe treatment, provided the dose is less than 15 mL.
描述将乙醇直接注射到有症状的椎体血管瘤中的技术及结果。
11例因椎体血管瘤导致截瘫（6例）或神经根病（5例）的患者，在计算机断层扫描（CT）引导下将乙醇（5 - 50毫升）直接注射到病变部位进行治疗。治疗前CT血管造影对于识别血管瘤的功能性血管间隙及指导针的放置至关重要。
在随访血管造影和钆增强磁共振成像中，所有血管瘤均完全闭塞。6例截瘫患者中有5例完全康复：1例近期接受治疗的患者在辅助下可行走。5例神经根病患者中有4例病情改善。乙醇注射未引发即刻并发症。接受乙醇注射量最大的2例患者，分别为42毫升和50毫升，在治疗后4周和16周出现受累椎体病理性骨折。
只要剂量小于15毫升，将乙醇直接注射到有症状的椎体血管瘤中是一种有效且安全的治疗方法。
