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骨样骨瘤射频消融术中3-T磁共振成像(MRI)及计算机断层扫描(CT)表现与患者症状及治疗结果的相关性

Correlation of 3-T MRI and CT findings with patient symptoms and treatment outcome in radiofrequency ablation of osteoid osteoma.

作者信息

Kaptan Mehmet Ali, Acu Berat, Öztunalı Çiğdem, Çalışır Cüneyt, İnan Ulukan, Bilgin Muzaffer

机构信息

Osmangazi University Faculty of Medicine, Department of Radiology, Eskisehir, Turkey.

Osmangazi University Faculty of Medicine, Department of Radiology, Eskisehir, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2019 Jul;53(4):239-247. doi: 10.1016/j.aott.2019.04.015. Epub 2019 May 16.

Abstract

OBJECTIVE

The aim of this prospective study was to evaluate pre- and post-treatment MRI and CT findings of osteoid osteoma (OO) patients treated with radiofrequency thermo-ablation (RFTA) and to compare these findings with visual analog scale (VAS) scores.

METHODS

Sixteen patients (4 females and 12 males; mean age of 18.87 ± 8.75 years (range: 8-37)) with OO were examined with CT and MRI, at baseline and at an average of 3 months following the procedure. On pre- and post-procedural CT and MRIs, OO-related findings were recorded. Treatment success was evaluated with VAS scores.

RESULTS

Baseline VAS scores were 8 or 9 and follow-up scores were 0 or 1, indicating no early recurrences. Nidus diameters decreased significantly after the procedure (p = 0.027, p = 0.002, and p = 0.002; and p = 0.001, p = 0.001, p = 0.001 for AP, ML and CC nidus diameters for CT and MRI, respectively). The mean nidus volume were significantly decreased after the procedure (p = 0.001, for CT and MRI). On post-procedural images, cortical thickening, the signal intensity and contrast enhancement of the nidus and the extent of periostitis were significantly decreased (p = 0.019, p = 0.001, p = 0.001 and p = 0.034, respectively). There was no significant change in nidus calcification, perinidal cortical and intramedullary sclerosis, periosteal reaction, bone deformity, bone marrow and soft tissue edema, joint effusion and synovitis after the procedure (p = 0.253, p = 0.062, p = 0.245, p = 1, p = 1, p = 0.429, p = 0.371, p = 0.625, p = 1).

CONCLUSION

Although the changes in imaging findings may be helpful in early follow-up of OO patients treated with RFTA, these changes alone cannot be used with accuracy in predicting treatment response.

LEVEL OF EVIDENCE

Level IV, Therapeutic Study.

摘要

目的

本前瞻性研究旨在评估接受射频热消融(RFTA)治疗的骨样骨瘤(OO)患者治疗前后的MRI和CT表现,并将这些表现与视觉模拟量表(VAS)评分进行比较。

方法

对16例骨样骨瘤患者(4例女性,12例男性;平均年龄18.87±8.75岁(范围:8 - 37岁))在基线时以及术后平均3个月时进行CT和MRI检查。在术前和术后的CT及MRI上,记录与骨样骨瘤相关的表现。采用VAS评分评估治疗效果。

结果

基线VAS评分为8或9,随访评分为0或1,表明无早期复发。术后病灶直径显著减小(p = 0.027、p = 0.002、p = 0.002;CT和MRI的前后位、侧位和轴位病灶直径分别为p = 0.001、p = 0.001、p = 0.001)。术后病灶平均体积显著减小(CT和MRI均为p = 0.001)。在术后图像上,皮质增厚、病灶的信号强度和对比增强以及骨膜反应程度均显著降低(分别为p = 0.019、p = 0.001、p = 0.001和p = 0.034)。术后病灶钙化、病灶周围皮质和骨髓硬化、骨膜反应、骨畸形、骨髓和软组织水肿、关节积液及滑膜炎无显著变化(p = 0.253、p = 0.062、p = 0.245、p = 1、p = 1、p = 0.429、p = 0.371、p = 0.625、p = 1)。

结论

尽管影像学表现的变化可能有助于对接受RFTA治疗的骨样骨瘤患者进行早期随访,但仅凭这些变化不能准确预测治疗反应。

证据水平

IV级,治疗性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e088/6739297/96ebcc4a288e/gr1.jpg

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