Department of Emergency and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy.
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Radiol Med. 2020 Jun;125(6):578-584. doi: 10.1007/s11547-020-01134-w. Epub 2020 Feb 10.
Interventional radiology is today considered the first-line treatment for osteoid osteoma both in the form of needle-guided technique of ablation (Radiofrequency) and of needleless technique (magnetic resonance-guided focused ultrasound surgery). The follow-up study of the procedures is mainly clinical, since the disappearance of pain is consistent with the success of the procedure. However, due to the minimally invasive and innovative nature of the approach, interpretation of the follow-up imaging could be ambiguous and misleading. Aim of our review was to define the main findings on the imaging that can best describe the regular evolution of these types of treatment. In particular, four findings were considered: (1) bone marrow oedema; (2) reactive phenomena (perilesional inflammatory reaction for extra-articular lesions or synovial reaction for intra-articular lesions); (3) bone remodelling (disappearance of the nidus and bone healing); (4) ring sign (considered as the granulation tissue around the nidus treated). These findings were evaluated using MRI and CT with a follow-up study that lasted up to 24 months.
介入放射学今天被认为是骨样骨瘤的一线治疗方法，无论是在消融的针引导技术（射频）还是无针技术（磁共振引导聚焦超声手术）的形式下。该手术的随访研究主要是临床的，因为疼痛的消失与手术的成功一致。然而，由于该方法具有微创和创新性，对随访影像学的解释可能存在歧义和误导。我们的综述旨在定义在影像学上可以最好地描述这些类型治疗的常见演变的主要发现。具体而言，考虑了四种发现：（1）骨髓水肿；（2）反应现象（关节外病变的周围炎症反应或关节内病变的滑膜反应）；（3）骨重塑（病灶消失和骨愈合）；（4）环征（被认为是治疗后病灶周围的肉芽组织）。这些发现使用 MRI 和 CT 进行评估，并进行了长达 24 个月的随访研究。
