Kim Yun Hyun, Ryu Jeong Yeop, Lee Joon Seok, Lee Seok Jong, Lee Jong Min, Lee Sang Yub, Huh Seung, Kim Ji Yoon, Chung Ho Yun
Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea.
Arch Plast Surg. 2021 Nov;48(6):622-629. doi: 10.5999/aps.2021.00913. Epub 2021 Nov 15.
Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision.
Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement.
Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group.
Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.
静脉畸形（VMs）是最常见的血管畸形类型。肌内静脉畸形（IMVMs）是累及肌肉的病变，不包括肌内血管瘤。本研究的目的是比较接受硬化治疗的IMVM患者与接受手术切除的患者的临床结局。
在一家单一的血管异常医疗中心于2011年7月至2020年8月期间治疗的492例VM患者中，对63例诊断为IMVM的患者进行回顾性分析。主观评估疼痛、活动受限、肿胀和生活质量（QOL），同时由该中心合格的放射科医生评估影像学结局。还评估了并发症发生率，并通过影像学和临床检查来确定哪个治疗组（硬化治疗或手术切除）改善更大。
尽管两个治疗组在疼痛（P=0.471）、肿胀（P=0.322）或并发症发生率（P=0.206）方面无显著差异，但手术治疗组在活动受限（P=0.010）、QOL（P=0.013）和影像学结局（P=0.017）方面表现出明显更好的结果。此外，双功超声和磁共振成像均显示手术切除组的临床结局改善程度大于硬化治疗组。
尽管已有多项研究探讨了IMVM的治疗方法，但尚未制定明确的治疗选择指南。基于本研究结果，强烈鼓励采用手术切除治疗IMVM。
