Guibaud L, Herbreteau D, Dubois J, Stempfle N, Bérard J, Pracros J P, Merland J J
Department of Pediatric Imaging, Hôpital Debrousse, Université Lyon-Sud, France.
Radiology. 1998 Aug;208(2):369-73. doi: 10.1148/radiology.208.2.9680561.
To assess the efficacy of percutaneous embolization with an alcoholic solution of zein in the treatment of aneurysmal bone cysts.
Eighteen patients with aneurysmal bone cysts were treated percutaneously with alcoholic zein. The cysts were in the lower limb (n = 7), upper limb (n = 5), pelvis (n = 3), cervical spine (n = 2), and mandible (n = 1). All patients were symptomatic, three had previously undergone surgery. Percutaneous embolization was performed with fluoroscopic or computed tomographic guidance with the patient under general anesthesia. Clinical and imaging follow-up lasted 18 months to 4 years.
Percutaneous embolization was performed in 16 cases. In two cases, cystograms showed marked venous drainage and thus embolization was not attempted. Six patients underwent repeat embolization. Complications consisted of a local transitory inflammatory reaction (n = 5), aseptic osteitis (n = 1), and a small pulmonary infarct without sequelae (n = 1). Relief of symptoms was achieved in all patients except one, who underwent surgery. At imaging, improvement was total in 13 cases (87%) and partial in two cases (13%). No recurrence was noted during follow-up.
Percutaneous embolization of aneurysmal bone cysts with alcoholic zein should be considered a reliable alternative to surgery, especially in cases with a difficult surgical approach or cases of postsurgical recurrence.
评估用玉米醇溶蛋白酒精溶液经皮栓塞治疗骨动脉瘤样囊肿的疗效。
18例骨动脉瘤样囊肿患者接受了玉米醇溶蛋白酒精溶液经皮治疗。囊肿位于下肢（7例）、上肢（5例）、骨盆（3例）、颈椎（2例）和下颌骨（1例）。所有患者均有症状，3例曾接受过手术。在全身麻醉下，在透视或计算机断层扫描引导下进行经皮栓塞。临床和影像学随访持续18个月至4年。
16例患者进行了经皮栓塞。2例患者囊肿造影显示有明显的静脉引流，因此未尝试栓塞。6例患者接受了重复栓塞。并发症包括局部短暂性炎症反应（5例）、无菌性骨炎（1例）和1例无后遗症的小面积肺梗死。除1例接受手术的患者外，所有患者症状均得到缓解。影像学检查显示，13例（87%）完全改善，2例（13%）部分改善。随访期间未发现复发。
用玉米醇溶蛋白酒精溶液经皮栓塞骨动脉瘤样囊肿应被视为手术的可靠替代方法，尤其是在手术入路困难或术后复发的病例中。
