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目的初步探讨MR引导下聚焦超声治疗疼痛性骨样骨瘤的可行性、安全性和临床有效性。材料与方法本项前瞻性研究获得经机构审查委员会批准,共包括连续6例(男5例,女1例;平均年龄21岁)临床和影像诊断为骨样骨瘤的病人。所有病人均在签署知情同意书后行MR引导下聚焦超声消融治疗。除外位于椎体内的病灶。记录声裂数和能量沉积。治疗后第1、3、6个月时确定治疗是否成功。应用直观类比标度(VAS)疼痛评分法评估症状的变化。观察在基线时和术后随访过程中骨样骨瘤的MR影像特征(水肿、充血和血管巢)。结果应用平均声裂为(4±1.8)和平均能量为(866±211)J的条件行此项治疗。无治疗或麻醉相关的并发症发生。术前和术后的平均VAS评分变化显著(分别为7.9±1.4和0.0±0.0)。所有病灶内的骨样骨瘤相关水肿和充血均逐渐消退。然而,4/6例病人的血管巢在治疗后依然存在。结论有限的研究样本显示骨样骨瘤的MR引导下聚焦超声治疗的安全性良好、成功率高且治疗相关的死亡率很低。
Objective To investigate the feasibility, safety and clinical efficacy of MR guided focused osteosynthesis in the treatment of painful osteoid osteoma. Materials and Methods This prospective study was approved by the Institutional Review Board and included a total of 6 patients (5 males and 1 females; mean age 21 years) in clinical and imaging diagnosis of osteoid osteoma. All patients underwent MR-guided ultrasound ablation after signed informed consent. Except in the vertebral lesions. Record the number of cleavages and energy deposition. 1, 3, 6 months after treatment to determine the success of the treatment. Visual analog scale (VAS) pain score was used to evaluate the change of symptoms. MR imaging features of osteoid osteoma (edema, congestion, and vascular nests) were observed at baseline and postoperative follow-up. Results The average sonic cleavage was (4 ± 1.8) and the average energy of (866 ± 211) J conditions of this line of treatment. No treatment or anesthesia related complications occurred. The mean VAS scores before and after surgery changed significantly (7.9 ± 1.4 and 0.0 ± 0.0, respectively). All lesions of osteoid osteoma associated edema and congestion are gradually subsided. However, the vessel nests of 4 of 6 patients remained after treatment. Conclusions A limited sample of studies have shown that osteoporotic osteomas have MR-guided Focused Ultrasounds with good safety, high success rate and low treatment-related mortality.