Christie-Large M, Evans N, Davies A M, James S L J
Department of Radiology, The Royal Orthopaedic Hospital Foundation Trust, Bristol Road South, Northfield, Birmingham, B31 2AP, UK.
Skeletal Radiol. 2008 Nov;37(11):1011-7. doi: 10.1007/s00256-008-0526-4. Epub 2008 Jul 19.
The aim of this study is to describe the procedure technique, clinical and imaging outcomes of patients treated with radiofrequency ablation for chondroblastoma.
Four patients (female/male, 3:1; mean age, 13 years; age range; 9-16 years) underwent the procedure. All had pre-operative magnetic resonance imaging (MRI) and symptomatic, biopsy-proven chondroblastomas (two proximal femur, two proximal tibia). The lesion size ranged from 1.5 to 2.5 cm in maximal dimension (mean size, 1.8 cm). Bone access was gained with a Bonopty biopsy needle system (mean number of radiofrequency needle placements, 5; mean ablation time, 31 min).
Clinical and MRI follow-up was available in all cases (mean, 12.25 months; range, 5-18 months). All patients reported resolution of symptoms at 2-6 weeks post ablation. At their most recent clinical follow-up, three patients remained completely asymptomatic with full return to normal activities and one patient had minor local discomfort (different pain pattern) that was not limiting activity. All four patients' follow-up MRI studies demonstrated resolution of the oedema pattern around the lesion and temporal evolution of the internal signal characteristics with fatty replacement.
Radiofrequency ablation for chondroblastoma provides an alternative to surgical curettage, and we have demonstrated both a clinical improvement in symptoms and the follow-up MRI appearances.
本研究旨在描述采用射频消融治疗成软骨细胞瘤患者的手术技术、临床及影像学结果。
4例患者(女/男,3:1;平均年龄13岁;年龄范围9 - 16岁)接受了该手术。所有患者术前行磁共振成像(MRI)检查,且均有经活检证实的有症状的成软骨细胞瘤(2例位于股骨近端,2例位于胫骨近端)。病变最大径为1.5至2.5 cm(平均大小1.8 cm)。采用Bonopty活检针系统进入骨质(平均射频针置入次数5次;平均消融时间31分钟)。
所有病例均有临床及MRI随访(平均12.25个月;范围5 - 18个月)。所有患者均报告在消融后2 - 6周症状缓解。在最近的临床随访中,3例患者完全无症状,恢复正常活动,1例患者有轻微局部不适(疼痛模式不同),但不影响活动。所有4例患者的随访MRI研究均显示病变周围水肿模式消失,内部信号特征随脂肪替代出现时间性演变。
射频消融治疗成软骨细胞瘤为手术刮除提供了一种替代方法,我们已证明其在症状方面有临床改善以及随访MRI表现良好。