Prud'homme Clara, Nueffer Jean-Philippe, Runge Michel, Dubut Jonathan, Kastler Bruno, Aubry Sébastien
Department of Musculoskeletal Imaging, University Hospital of Besancon, 25000, Besancon, France.
I4S Laboratory, INSERM EA4268, University of Franche-Comte, 25000, Besancon, France.
Skeletal Radiol. 2017 Mar;46(3):315-323. doi: 10.1007/s00256-016-2558-5. Epub 2016 Dec 27.
The aims of this work were to assess the feasibility and efficacy of CT-guided microwave ablation (MWA) in the treatment of osteoid osteomas (OOs).
Thirteen consecutive patients (range 11-31 years old) presenting with OO were prospectively included and treated by CT-guided MWA. Power and duration of MWA were both recorded. The patient's pain was assessed using a numeric pain rating scale (NRS), and side effects were recorded during procedures, after 1 day, 7 days and 1 month. The nidus vascularization and the volume of necrosis induced by MWA were assessed using contrast-enhanced MRI. Success was defined as the complete relief of the patient's pain 1 month after the first procedure, associated with necrosis of the nidus on follow-up MRI.
The success rate was up to 92.3% (12/13). At 1 day, 7 days and 1 month, the median NRSs were respectively 5 [interquartile range (IQR) 2-5], 0 (IQR 0-1) and 0 (IQR 0-0). Side effects observed were one partial and self-resolving lesion of a sensory branch of the radial nerve and two skin burns. The median power of the MWA used was 60 W (IQR 50-60) with a 1.5-min duration (IQR 1-2), leading to MWA-induced necrosis measuring on average 23 × 15 × 16 mm.
CT-guided MWA of OO has a success rate that appears to be almost similar to that of laser or radiofrequency ablation, but care must be taken to prevent nerve or skin lesions.
本研究旨在评估CT引导下微波消融（MWA）治疗骨样骨瘤（OO）的可行性和疗效。
前瞻性纳入13例连续的骨样骨瘤患者（年龄范围11 - 31岁），并采用CT引导下MWA进行治疗。记录MWA的功率和持续时间。使用数字疼痛评分量表（NRS）评估患者的疼痛情况，并在操作过程中、术后1天、7天和1个月记录副作用。采用对比增强MRI评估MWA诱导的瘤巢血管化和坏死体积。成功定义为首次治疗后1个月患者疼痛完全缓解，且随访MRI显示瘤巢坏死。
成功率高达92.3%（12/13）。术后1天、7天和1个月时，NRS中位数分别为5[四分位间距（IQR）2 - 5]、0（IQR 0 - 1）和0（IQR 0 - 0）。观察到的副作用包括1例桡神经感觉支部分性且可自行缓解的损伤和2例皮肤烧伤。所用MWA的中位功率为60W（IQR 50 - 60），持续时间为1.5分钟（IQR 1 - 2），导致MWA诱导的坏死平均大小为23×15×16mm。
CT引导下MWA治疗骨样骨瘤的成功率似乎与激光或射频消融相近，但必须注意预防神经或皮肤损伤。
