Sgalambro Ferruccio, Zugaro Luigi, Bruno Federico, Palumbo Pierpaolo, Salducca Nicola, Zoccali Carmine, Barile Antonio, Masciocchi Carlo, Arrigoni Francesco
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
San Salvatore Hospital, 67100 L'Aquila, Italy.
J Clin Med. 2022 Jun 7;11(12):3265. doi: 10.3390/jcm11123265.
Interventional Radiology (IR) has experienced an exponential growth in recent years. Technological advances of the last decades have made it possible to use new treatments on a larger scale, with good results in terms of safety and effectiveness. In musculoskeletal field, painful bone metastases are the most common target of IR palliative treatments; however, in selected cases of bone metastases, IR may play a curative role, also in combination with other techniques (surgery, radiation and oncology therapies, etc.). Primary malignant bone tumors are extremely rare compared with secondary bone lesions: osteosarcoma, Ewing sarcoma, and chondrosarcoma are the most common; however, the role of interventional radiology in this fiels is marginal. In this review, the main techniques used in interventional radiology were examined, and advantages and limitations illustrated. Techniques of ablation (Radiofrequency, Microwaves, Cryoablation as also magnetic resonance imaging-guided high-intensity focused ultrasound), embolization, and Cementoplasty will be described. The techniques of ablation work by destruction of pathological tissue by thermal energy (by an increase of temperature up to 90 °C with the exception of the Cryoablation that works by freezing the tissue up to -40 °C). Embolization creates an ischemic necrosis by the occlusion of the arterial vessels that feed the tumor. Finally, cementoplasty has the aim of strengthening bone segment weakened by the growth of pathological tissue through the injection of cement. The results of the treatments performed so far were also assessed and presented focused the attention on the management of bone metastasis.
近年来，介入放射学（IR）呈指数级增长。过去几十年的技术进步使得大规模应用新治疗方法成为可能，在安全性和有效性方面都取得了良好效果。在肌肉骨骼领域，疼痛性骨转移瘤是IR姑息治疗最常见的靶点；然而，在某些骨转移瘤病例中，IR也可能发挥治愈作用，也可与其他技术（手术、放疗和肿瘤治疗等）联合使用。与继发性骨病变相比，原发性恶性骨肿瘤极为罕见：骨肉瘤、尤因肉瘤和软骨肉瘤最为常见；然而，介入放射学在这一领域的作用微不足道。在本综述中，研究了介入放射学中使用的主要技术，并阐述了其优缺点。将描述消融技术（射频、微波、冷冻消融以及磁共振成像引导下的高强度聚焦超声）、栓塞术和骨水泥成形术。消融技术通过热能破坏病理组织（除冷冻消融通过将组织冷冻至-40°C外，其他通过将温度升高至90°C）来发挥作用。栓塞术通过阻塞为肿瘤供血的动脉血管造成缺血性坏死。最后，骨水泥成形术旨在通过注入骨水泥来强化因病理组织生长而变弱的骨段。还评估了迄今为止所进行治疗的结果，并重点关注了骨转移瘤的管理。
