Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
PLoS One. 2020 Oct 29;15(10):e0241347. doi: 10.1371/journal.pone.0241347. eCollection 2020.
To report the clinical and MRI-based volumetric mid-term outcome after image guided percutaneous sclerotherapy (PS) of venous malformations (VM) of the head and neck.
A retrospective analysis of a prospectively maintained database was performed, including patients with VM of the head and neck who were treated with PS. Only patients with available pre- and post-interventional MRI were included into this study. Clinical outcome, which was subjectively assessed by the patients, their parents (for paediatric patients) and/or the physicians, was categorized as worse, unchanged, minor or major improvement. Radiological outcome, determined by MRI-based volumetric measurements, was categorized as worse (>10% increase), unchanged (≤10% increase to <10% decrease), minor (≥10% to <25% decrease), intermediate (≥25% to <50% decrease) or major improvement (≥50% decrease).
Twenty-seven patients were treated in 51 treatment sessions. After a mean follow-up of 31 months, clinical outcome was worse for 7.4%, unchanged for 3.7% of the patients, while there was minor and major improvement for 7.4% and 81.5%, respectively. In the volumetric imaging analysis 7.4% of the VMs were worse and 14.8% were unchanged. Minor improvement was observed in 22.2%, intermediate improvement in 44.4% and major improvement in 11.1%. The rate of permanent complications was 3.7%.
PS can be an effective therapy to treat the symptoms of patients with VMs of the head and neck and to downsize the VMs. MRI-based volumetry can be used to objectively follow the change in size of the VMs after PS. Relief of symptoms frequently does not require substantial volume reduction.
报告经影像引导经皮硬化治疗（PS）后头颈部静脉畸形（VM）的临床和基于 MRI 的中期体积学结果。
对前瞻性维护的数据库进行回顾性分析，包括接受 PS 治疗的头颈部 VM 患者。只有具有可获得的术前和术后 MRI 的患者才被纳入本研究。临床结果由患者、其父母（对于儿科患者）和/或医生主观评估，分为恶化、不变、轻微改善或显著改善。通过基于 MRI 的体积测量确定的放射学结果分为恶化（>10%增加）、不变（≤10%增加至<10%减少）、轻微（≥10%至<25%减少）、中度（≥25%至<50%减少）或显著改善（≥50%减少）。
27 例患者共进行了 51 次治疗。平均随访 31 个月后，7.4%的患者临床结果恶化，3.7%的患者不变，7.4%的患者有轻微改善，81.5%的患者有显著改善。在体积成像分析中，7.4%的 VM 恶化，14.8%不变。轻微改善见于 22.2%，中度改善见于 44.4%，显著改善见于 11.1%。永久性并发症发生率为 3.7%。
PS 可有效治疗头颈部 VM 患者的症状并缩小 VM。基于 MRI 的体积测量可用于客观随访 PS 后 VM 大小的变化。症状缓解通常不需要大量的体积减少。
