Radiology Department, APHM, Marseille, France.
Aix-Marseille Université, CNRS, ISM UMR 7287, Marseille, France.
Eur Radiol. 2018 Jun;28(6):2336-2344. doi: 10.1007/s00330-017-5164-6. Epub 2018 Jan 2.
To evaluate the technical feasibility and efficacy of percutaneous cryoablation for the treatment of osteoid osteoma (OO) in adults.
21 patients (12 male and nine female; mean age, 29.9 years) who underwent CT-guided percutaneous cryoablation for the treatment of OO were retrospectively evaluated. Procedures were carried out under local anaesthesia and conscious sedation in 13 patients, and under general anaesthesia in eight patients. Then, the ablation zone was evaluated with post-procedure magnetic resonance imaging at 6 weeks. Clinical outcome was assessed using a visual analogue scale (VAS) to evaluate severity of pain before procedure, as well as at primary (6 weeks) and secondary follow-up (6-40 months).
All procedures were technically successful. Median VAS scores were: 8 (range, 5-10) before procedure and after procedure, respectively, 0 (range, 0-2; p < .0001) and 0 (range, 0-7; p < .0001) at primary and secondary follow-up. There were three minor complications (14.3%) and no major complication. A single patient reported symptom recurrence (4.8%) at secondary follow-up and successfully underwent a second cryoablation procedure.
CT-guided percutaneous cryoablation is safe and effective in the treatment of OO in adults, and can be accomplished without general anaesthesia in selected cases.
• CT-guided percutaneous cryoablation of osteoid osteoma is safe and effective • Cryoablation allows precise visual control of the aggregated iceball during procedure • Percutaneous cryoablation can be accomplished without general anaesthesia in selected cases • Another advantage of cryoablation is reduction of immediate postprocedural pain • Post-procedure MRI is helpful in the evaluation of technical success.
评估 CT 引导下经皮冷冻消融治疗成人骨样骨瘤（OO）的技术可行性和疗效。
回顾性分析 21 例（男 12 例，女 9 例；平均年龄 29.9 岁）接受 CT 引导下经皮冷冻消融治疗 OO 的患者。13 例患者在局部麻醉和清醒镇静下进行手术，8 例患者在全身麻醉下进行手术。然后，在术后 6 周时使用磁共振成像评估消融区。使用视觉模拟评分（VAS）评估术前、初次（6 周）和二次随访（6-40 个月）时疼痛的严重程度来评估临床疗效。
所有手术均技术成功。中位 VAS 评分分别为：术前 8 分（范围 5-10 分），术后 0 分（范围 0-2 分；p <.0001）和 0 分（范围 0-7 分；p <.0001），初次和二次随访时。有 3 例轻微并发症（14.3%），无重大并发症。1 例患者在二次随访时出现症状复发（4.8%），成功接受了第二次冷冻消融治疗。
CT 引导下经皮冷冻消融治疗成人 OO 安全有效，在选择的病例中可以在不使用全身麻醉的情况下完成。
CT 引导下经皮冷冻消融治疗骨样骨瘤安全有效。
冷冻消融术允许在手术过程中精确观察聚集的冰球。
在选择的病例中，可以在不使用全身麻醉的情况下完成经皮冷冻消融术。
冷冻消融术的另一个优点是减少术后即刻疼痛。
术后 MRI 有助于评估技术成功。
