Fanucci Ezio, Masala Salvatore, Fabiano Sebastiano, Perugia Dario, Squillaci Ettore, Varrucciu Viviana, Simonetti Giovanni
Department of Diagnostic Imaging and Interventional Radiology, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
Eur Radiol. 2004 Mar;14(3):514-8. doi: 10.1007/s00330-003-2057-7. Epub 2003 Oct 3.
Morton's neuroma (MN) is a frequent cause of metatarsalgia. The aim of our study was to evaluate the efficacy of neuroma alcohol-sclerosing therapy (NAST) under US guide in MN after a 10-month follow-up. Forty intermetatarsal neuromas underwent alcohol-sclerosing therapy after sonographic evaluation of their dimensions and echotexture. After subcutaneous anesthesia, a sclerosing solution composed of anesthetic (carbocaine-adrenaline 70%) and ethylic alcohol (30%) was injected inside the mass under US guidance. The procedure was repeated at intervals of 15 days until the resolution of the symptoms. A total or partial symptomatic relief was obtained in 36 cases (90%). No procedure-related complications were observed. Transitory plantar pain, due to the flogistic reaction induced by the sclerosing solution, occurred in 6 cases (15%). The 10-month follow-up revealed a 20-30% mass volume reduction and an adiposus-like change in echotexture. In the 4 cases (10%) of therapeutic failure, the preliminary sonography demonstrated a hypoechoic echotexture with a strong US beam attenuation corresponding to a highly fibrous neuroma after surgical resection. The NAST is a feasible and cost-efficient procedure with high rates of therapeutic success.
莫顿神经瘤（MN）是跖痛症的常见病因。我们研究的目的是在10个月的随访后评估超声引导下神经瘤酒精硬化疗法（NAST）对MN的疗效。40例跖间神经瘤在超声评估其大小和回声纹理后接受了酒精硬化治疗。在局部麻醉后，在超声引导下将由麻醉剂（卡波卡因 - 肾上腺素70%）和乙醇（30%）组成的硬化溶液注入肿块内。每隔15天重复该操作，直到症状缓解。36例（90%）获得了完全或部分症状缓解。未观察到与操作相关的并发症。6例（15%）出现了由于硬化溶液引起的炎症反应导致的短暂足底疼痛。10个月的随访显示肿块体积减少了20 - 30%，回声纹理出现了类似脂肪样的变化。在4例（10%）治疗失败的病例中，术前超声显示低回声纹理，伴有强烈的超声束衰减，手术切除后对应高度纤维化的神经瘤。NAST是一种可行且经济高效的治疗方法，治疗成功率高。
