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[放射性引导手术在骨样骨瘤手术治疗中的应用]

[Use of radioguided surgery in the surgical treatment of osteoid osteoma].

作者信息

Infante J R, Lorente R, Rayo J I, Serrano J, Domínguez M L, García L, Moreno M

机构信息

Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, España.

Servicio de Traumatología, Complejo Hospitalario Universitario de Badajoz, Badajoz, España.

出版信息

Rev Esp Med Nucl Imagen Mol. 2015 Jul-Aug;34(4):225-9. doi: 10.1016/j.remn.2015.01.003. Epub 2015 Mar 3.

Abstract

OBJECTIVE

Osteoid osteoma is the third most common benign bone tumor and complete surgical resection is definitive treatment. There are a limited number of publications on the use of radioguided surgery in this type of lesion. To assess the utility of radioguided surgery in our environment as a method of surgical treatment of this tumor.

MATERIAL AND METHODS

We retrospectively evaluated 12 patients (2 women and 10 men, age range 9-44 years) with clinical and radiological suspicion of osteoid osteoma. Bone scintigraphy showed foci of pathology uptake compatible with suspected lesion in the femur (4 cases), tibia (3), vertebral column (3), humerus (1) and talus (1). Subsequently patients underwent surgical treatment by radioguided surgery after injection of a dose of (99m)Tc-hydroxy diphosphonate. The nidus was removed using gamma probe and mini gamma camera, considering the technique to be completed when its counts decreased to the levels of the surrounding bone counts.

RESULTS

Lesions were located in all patients (12 of 12), and were confirmed histologically in 8 of them, including an osteoblastoma. The cure rate was 100%, based on the disappearance of pain after a minimum follow-up of 6 months.

CONCLUSION

Use of radioguided surgery in the surgical treatment of osteoid osteoma showed satisfactory results, with 100% efficiency in both lesion location and outcome of treatment and without major postoperative complications.

摘要

目的

骨样骨瘤是第三常见的良性骨肿瘤,完整的手术切除是确定性治疗方法。关于在这类病变中使用放射性引导手术的文献数量有限。本研究旨在评估在我们的医疗环境中,放射性引导手术作为该肿瘤手术治疗方法的实用性。

材料与方法

我们回顾性评估了12例临床及影像学怀疑为骨样骨瘤的患者(2例女性,10例男性,年龄范围9 - 44岁)。骨闪烁显像显示,股骨(4例)、胫骨(3例)、脊柱(3例)、肱骨(1例)和距骨(1例)存在与疑似病变相符的病理性摄取灶。随后,患者在注射一剂(99m)锝 - 羟基二膦酸盐后接受放射性引导手术治疗。使用γ探测器和微型γ相机切除瘤巢,当计数降至周围骨计数水平时,认为该技术完成。

结果

所有患者(12例中的12例)病变均被定位,其中8例经组织学证实,包括1例骨母细胞瘤。基于至少6个月的随访后疼痛消失,治愈率为100%。

结论

放射性引导手术在骨样骨瘤的手术治疗中显示出令人满意的结果,在病变定位和治疗结果方面效率均为100%,且无重大术后并发症。

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