Pastor Maxime, Grange Sylvain, Daly-Eraya Dimitri, Maldinez Mickaël, Delpont Marion, Cyteval Catherine
Département d'Imagerie Médicale, Hôpital Lapeyronie - Université de Montpellier, 371 avenue du Doyen Gaston Giraud, Montpellier, 34295 Cedex 5, France.
Centre Hospitalier Universitaire de Saint-Étienne, Saint-Etienne, France.
Pediatr Radiol. 2025 Jul 16. doi: 10.1007/s00247-025-06329-9.
Aneurysmal bone cysts (ABCs) are benign bone lesions frequently observed in children and adolescents. These cysts can form in any part of the skeleton and are characterized by fluid-filled cavities surrounded by fibrous tissue.
This study aims to evaluate the efficacy and safety of interventional radiology treatment by intra-cystic alcohol sclerotherapy of ABCs abutting the growth plate in pediatric patients.
A retrospective study was conducted across two hospital centers between January 2012 and June 2022. The study included patients diagnosed with ABCs abutting the growth plate and treated via intra-cystic alcohol sclerotherapy. The radiographic diagnosis of ABCs was confirmed using radiographs and magnetic resonance imaging (MRI), and a biopsy was performed for definitive confirmation. The patients were followed up for a minimum of 12 months post-alcohol sclerotherapy.
A total of 14 patients were included in the study, with 13 active ABCs and one aggressive ABC, based on the Capanna classification. The mean clinical and radiological follow-up after sclerotherapy was 36.1 months ± 17.4 months. No epiphysiodesis was reported in any of the patients. At least 1 year after the procedure, 13 of the 14 patients did not present any pain; 12 of 14 patients did not require surgery; one patient presented with a fracture; and one presented with asymmetry of the lower limbs after surgery. New bone formation and/or increased cortical thickness were considered major in three ABCs (score I on the modified Neer classification) and significant in nine ABCs (score II on the modified Neer classification).
Alcohol sclerotherapy of active ABCs abutting the growth plate shows no short-term complications and poses no risk of epiphysiodesis. This suggests that alcohol sclerotherapy could be a safe and effective treatment option for ABCs abutting the growth plate in pediatric patients.
This study supports alcohol sclerotherapy as a minimally invasive, safe, and effective treatment for pediatric ABCs near the growth plate, potentially reducing the need for surgical interventions.
骨动脉瘤样囊肿（ABCs）是儿童和青少年中常见的良性骨病变。这些囊肿可形成于骨骼的任何部位，其特征是由纤维组织包围的充满液体的腔隙。
本研究旨在评估介入放射学治疗方法——对儿科患者生长板附近的ABCs进行囊内酒精硬化治疗的疗效和安全性。
在2012年1月至2022年6月期间，在两个医院中心进行了一项回顾性研究。该研究纳入了被诊断为生长板附近ABCs并接受囊内酒精硬化治疗的患者。ABCs的影像学诊断通过X线片和磁共振成像（MRI）得以确认，并进行了活检以明确诊断。患者在酒精硬化治疗后至少随访12个月。
根据卡潘纳分类，该研究共纳入14例患者；其中有13个活动性ABCs和1个侵袭性ABC。硬化治疗后的平均临床和影像学随访时间为36.1个月±17.4个月。所有患者均未报告骨骺固定情况。在治疗后至少1年，14例患者中有13例无任何疼痛；14例患者中有12例无需手术；1例患者出现骨折；1例患者术后出现下肢不对称。在3个ABCs中，新骨形成和/或皮质增厚被认为是主要的（改良尼尔分类法中的I级），在9个ABCs中是显著的（改良尼尔分类法中的II级）。
对生长板附近的活动性ABCs进行酒精硬化治疗未显示短期并发症，也不存在骨骺固定风险。这表明酒精硬化治疗可能是儿科患者生长板附近ABCs的一种安全有效的治疗选择。
本研究支持酒精硬化治疗作为一种微创、安全且有效的治疗方法，用于治疗生长板附近的儿科ABCs，可能减少手术干预的需求。
