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骨样骨瘤患者CT引导下射频消融的治疗结果

Therapeutic outcome of CT-guided radiofrequency ablation in patients with osteoid osteoma.

作者信息

Lassalle Louis, Campagna R, Corcos G, Babinet A, Larousserie F, Stephanazzi J, Feydy A

机构信息

Service de radiologie ostéo-articulaire, Hopital Cochin-APHP Paris Université Paris Descartes, Paris, France.

Service de chirurgie orthopédique, Hopital Cochin-APHP Paris Université Paris Descartes, Paris, France.

出版信息

Skeletal Radiol. 2017 Jul;46(7):949-956. doi: 10.1007/s00256-017-2658-x. Epub 2017 Apr 20.

Abstract

OBJECTIVE

To assess the long-term outcome of computed tomography-guided radiofrequency ablation (CT-guided RFA) in patients with suspected osteoid osteoma (OO).

MATERIALS AND METHODS

Single-center retrospective study. Patients with clinical suspicion and imaging diagnosis of osteoid osteoma were treated by CT-guided RFA using the same device with either a 7- or 10-mm active tip electrode. Specific precautions were applied in case of articular or spinal OO. Patients were contacted by phone to evaluate the long-term outcome in terms of pain, ability to perform daily activities (including sports), and long-term complications. Success was defined as the absence of residual pain and ability to perform daily activities normally.

RESULTS

From 2008 to 2015, 126 patients were treated by CT-guided RFA for OO in our institution. Mean patient age was 26.1 years (SD = 11, range 1-53); mean delay to diagnosis was 16.9 months (SD = 15.2, range 1-120). Among patients who answered the follow-up call (n = 88), the overall success rate was 94.3%: 79/88 (89.8%) had primary success of the procedure, and 4/88 (4.5%) had a secondary success (repeat-RFA after pain recurrence). Mean follow-up time was 34.6 months (SD = 24.7, range 3-90). Few complications occurred: two mild reversible peripheral nerve injuries, one brachial plexus neuropathy, one broken electrode tip fragment, and one muscular hematoma.

CONCLUSION

Osteoid osteoma can be effectively and safely treated by CT-guided RFA using the presented ablation protocol. Beneficial effects of the treatment persist at long-term follow-up.

摘要

目的

评估计算机断层扫描引导下射频消融术(CT引导下RFA)治疗疑似骨样骨瘤(OO)患者的长期疗效。

材料与方法

单中心回顾性研究。对临床怀疑并经影像学诊断为骨样骨瘤的患者采用CT引导下RFA治疗,使用同一设备,配备7毫米或10毫米的有源尖端电极。对于关节或脊柱骨样骨瘤患者采取了特定的预防措施。通过电话联系患者,评估其在疼痛、日常活动能力(包括运动)和长期并发症方面的长期疗效。成功定义为无残留疼痛且能够正常进行日常活动。

结果

2008年至2015年,我院126例疑似骨样骨瘤患者接受了CT引导下RFA治疗。患者平均年龄为26.1岁(标准差=11,范围1 - 53岁);平均诊断延迟时间为16.9个月(标准差=15.2,范围1 - 120个月)。在回复随访电话的患者中(n = 88),总体成功率为94.3%:88例中有79例(89.8%)手术一次成功,4例(4.5%)二次成功(疼痛复发后重复RFA)。平均随访时间为34.6个月(标准差=24.7,范围3 - 90个月)。并发症较少:2例轻度可逆性周围神经损伤、1例臂丛神经病变、1例电极尖端碎片断裂和1例肌肉血肿。

结论

采用本消融方案,CT引导下RFA可有效、安全地治疗骨样骨瘤。治疗的有益效果在长期随访中持续存在。

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