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软骨母细胞瘤的射频消融:长期临床及影像学结果

Radiofrequency ablation of chondroblastoma: long-term clinical and imaging outcomes.

作者信息

Xie Cheng, Jeys Lee, James Steven L J

机构信息

Department of Oncology, The Royal Orthopaedic Hospital Foundation Trust, Bristol Road South, Northfield, Birmingham, B31 2AP, UK,

出版信息

Eur Radiol. 2015 Apr;25(4):1127-34. doi: 10.1007/s00330-014-3506-1. Epub 2014 Nov 30.

Abstract

OBJECTIVES

To investigate the long-term clinical and imaging outcomes of patients with chondroblastoma treated by radiofrequency ablation (RFA).

METHODS

Retrospective analysis of 25 consecutive patients treated with RFA from September 2006 to December 2013. Patients were reviewed within one month of the procedure, then every 3-6 months, and yearly for up to three years. Serial magnetic resonance imaging (MRI) was performed at follow-up to monitor recovery. Functional outcome was assessed using the Musculoskeletal Tumour Society Score (MSTS).

RESULTS

Pre-procedure MRI confirmed osteolytic lesions (size range 1.0-3.3 cm; mean 2.0 cm). Patients reported continued symptomatic improvement at four months review. Serial MRI confirmed progressive resolution of inflammation with fatty consolidation of cavity. 88 % of patients became asymptomatic during the follow up period. Three patients' (12 %) symptoms returned at 16, 22 and 24 months respectively after RFA. MRI and biopsy confirmed recurrence in these patients. Functional assessment using MSTS score had an average score of 97.5 %. Mean follow up for the study group was 49 months.

CONCLUSION

RFA is an effective alternative to surgery in the management of chondroblastoma. We recommend a multi-disciplinary approach and RFA should be considered as a first-line treatment. Long-term follow-up is required for timely detection of recurrences.

KEY POINTS

• RFA is a safe and effective technique in the treatment of chondroblastoma. • Positive outcomes in 88 % patients at mean follow-up period of 49 months. • Local recurrences occurred in 12 % cases. • Long-term follow-up is required for timely detection of recurrences. • RFA should be considered as a first-line treatment for chondroblastoma.

摘要

目的

探讨经射频消融(RFA)治疗的成软骨细胞瘤患者的长期临床及影像学结局。

方法

回顾性分析2006年9月至2013年12月连续接受RFA治疗的25例患者。在术后1个月内对患者进行复查,然后每3 - 6个月复查一次,持续3年每年复查一次。随访期间进行系列磁共振成像(MRI)以监测恢复情况。使用肌肉骨骼肿瘤学会评分(MSTS)评估功能结局。

结果

术前MRI证实为溶骨性病变(大小范围1.0 - 3.3 cm;平均2.0 cm)。患者在4个月复查时报告症状持续改善。系列MRI证实炎症逐渐消退,空洞出现脂肪填充。88%的患者在随访期间无症状。3例患者(12%)分别在RFA后16、22和24个月症状复发。MRI及活检证实这些患者复发。使用MSTS评分进行功能评估,平均得分97.5%。研究组平均随访49个月。

结论

RFA是成软骨细胞瘤治疗中手术的有效替代方法。我们建议采用多学科方法,RFA应被视为一线治疗方法。需要长期随访以及时发现复发。

关键点

• RFA是治疗成软骨细胞瘤的安全有效技术。• 平均随访49个月时88%患者预后良好。• 12%病例出现局部复发。• 需要长期随访以及时发现复发。• RFA应被视为成软骨细胞瘤的一线治疗方法。

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