透视下局部注射平阳霉素碘油乳剂治疗体表静脉畸形

目的：观察X线透视下局部注射平阳霉素碘油乳剂（pingyangmycin lipidol emulsion,PLE）治疗体表静脉畸形（venous malformation,VM）的方法、疗效和并发症。方法：对106例体表VM采用直接穿刺瘤腔造影观察病变范围、大小、有无引流静脉,确诊后行平阳霉素碘油乳剂瘤体内注射。结果：疗效优者70例,良者36例,未见无效者,有效率100%。未见皮肤坏死和异位栓塞等严重并发症。结论：X线透视下行局部穿刺瘤腔内注射PLE治疗体表VM具有定位准确、安全、有效等优点。     

体表海绵状血管瘤瘤体穿刺造影及平阳霉素碘油乳剂治疗

目的 回顾总结91例体表海绵状血管瘤的造影表现,评价瘤体注射平阳霉素碘油乳剂(PLE)治疗体表海绵状血管瘤的疗效.方法 对91例体表海绵状血管瘤采用直接穿刺瘤腔造影观察病变范围、大小、有无引流静脉,确诊后行平阳霉索碘油乳剂瘤体内注射.结果 瘤体造影表现单发或多发类圆囊形39例,团块状42例,葡萄串状5例,其他类型5例.治愈62例,有效29例,未见无效者.有效 率100%.未出现表面皮肤坏死和异位栓塞等并发症.结论 直接穿刺瘤体造影有助于病变的诊断.局部注射平阳霉素碘油乳剂治疗体表海绵状血管瘤可取得较好的疗效,操作方便、安全、无明显不良反应.     

平阳霉素联合地塞米松注射治疗低流量血管畸形的临床应用

目的 探讨平阳霉素联合地塞米松注射治疗低流量血管畸形的疗效.资料与方法 搜集2006年12月至2009年7月应用平阳霉素碘化油混合乳剂联合地塞米松注射治疗低流量血管畸形患者8例,均采用直接穿刺造影观察病变范围、大小、静脉引流,明确诊断后行畸形血管内注射药物,观察疗效及并发症.结果 经6～12个月随访,1例治愈,4例基本治愈,有效3例.未出现并发症.结论 平阳霉素混合液经皮注射治疗低流量静脉血管畸形是一种高效、安全的治疗方法.     

数字胃肠机透视下行无水乙醇联合平阳霉素瘤内多点注射治疗体表静脉畸形

目的 探讨X线透视下行无水乙醇平阳霉素治疗体表静脉畸形的疗效.方法 用一次性静脉输液针穿刺瘤体,先注入碘海醇显像,再分别注入无水乙醇,平阳霉素.结果 本组31例患者,经1次治疗.21例治愈,8例显效,总有效率93.5%.结论 X线透视下行无水乙醇、平阳霉素瘤体注射治疗特别适用于位置较深、边界不清的体表静脉畸形.     

经皮注射平阳霉素碘油乳剂治疗肝海绵状血管瘤

目的：探讨CT引导下经皮注射平阳霉素碘油乳剂治疗肝海绵状血管瘤的疗效及安全性。方法：选择肝海绵状血管瘤患者34例,瘤体直径为3．2～12．0cm,采用CT引导下经皮穿刺,注射平阳霉素碘油乳剂治疗肝海绵状血管瘤,注射剂量为6～20ml。所有病例术后3个月、半年、1年各复查CT1次。结果：经皮注射平阳霉素碘油乳剂后,29例血管瘤瘤体内碘油沉积良好,5例PLE不能完全充盈瘤灶。术后3～6个月,全部病例瘤体均有明显缩小,其中缩小达80％以上者18例,〉50％者14例,缩小〈50％者2例。本组病例未出现肝脏坏死、胆管毁损、胆囊坏死穿孔、急性胰腺炎等严重并发症。结论：经皮注射平阳霉素碘油乳剂治疗肝海绵状血管瘤是一种操作简便且安全高效的治疗方法。     

Klippel-Trenaunay综合征血管内硬化治疗的临床探讨

目的探讨Klippel-Trenaunay(KT)综合征血管内硬化治疗的疗效及安全性。方法6例KT综合征患者行顺行静脉造影、多普勒超声后行患肢动脉造影,并经动脉主干注入碘油平阳霉素乳剂,随访观察疗效及术后并发症。结果顺行静脉造影和多普勒超声显示单纯异常扩张浅静脉6例,深静脉无异常;动脉造影显示动脉二、三级分支增多,软组织内见染色影。术后并发症主要有肢体肿胀和感觉异常。随访8～40个月,5例肢体症状明显好转,1例症状反复。结论碘油平阳霉素乳剂血管内硬化治疗KT综合征能有效改善患肢症状。     

平阳霉素+碘油乳剂栓塞治疗肝海绵状血管瘤的疗效观察

目的 评价平阳霉素碘油乳剂栓塞肝海绵状血管瘤的临床疗效。方法 对18例患者采用Seldinger技术股动脉插管,将导管超选择至肿瘤供血动脉,缓慢注入利多卡因5-10 m1及平阳霉素碘油乳剂5-20 ml。栓塞前常规肌内注射杜冷丁50-100 mg;病变巨大、多支血供、病人年龄>60岁者,分次介入治疗。术后3-48个月CT、B超随访观察栓塞前后肿瘤直径大小变化、临床症状缓解情况及并发症。结果 18例肝海绵状血管瘤均见平阳霉素碘油完全充填。病灶完全消失9例,缩小50％以上7例,病灶缩小25％-50％2例。其中6例血管造影复查见病灶血管完全消失,载瘤动脉闭塞。临床症状好转率89％,无严重并发症。结论 平阳霉素碘油乳剂动脉栓塞肝海绵状血管瘤疗效良好,微创、安全、副作用少,可作为首选的治疗方法。     

平阳霉素碘油乳剂栓塞治疗肝血管瘤

目的：评价平阳霉素碘油乳剂拴塞治疗肝血管瘤的疗效。方法：采用Seldinger技术股动脉插管，将导管超选择肿瘤供血动脉后，注入平阳霉素碘油乳剂栓塞。术后6—12个月随访CT观察肿瘤直径大小变化及碘化油充填情况。结果：21例患者肿瘤体积均明显缩小。5例直径超过8CM血管瘤一次栓塞后缩小的肿瘤内仍有血管瘤结构，经再次栓塞后显示瘤体内碘化油充填良好，随访6个月肿瘤无增大趋势。无1例发生严重并发症。结论：平阳霉素碘油乳剂动脉栓塞肝血管瘤疗效良好，微创、安全、副作用小，可作为首选治疗方案。     

用氨甲喋呤+平阳霉素碘油乳剂介入治疗高风险子宫疤痕妊娠

目的探讨氨甲喋呤加平阳霉素碘油乳剂介入治疗高风险子宫切口疤痕妊娠(CSP)的疗效和安全性。方法选取临床确诊CSP且孕囊位于肌层向外生长、供血丰富、原始胚胎生长活性程度高的高风险者51例,使用氨甲喋呤+平阳霉素碘油乳剂行子宫动脉化疗栓塞术(UACE)治疗,术后观察患者副反应、并发症、临床效果。结果全部病例UACE治疗1次成功,并保留住子宫,术后副反应少、轻,无治疗相关并发症,临床跟踪观察4例和病理检查47例证实全部杀死胚胎,无大出血发生。结论使用氨甲喋呤+平阳霉素碘油乳剂行UACE治疗高风险CSP临床效果好、安全性高。     

碘油平阳霉素乳剂和聚乙烯醇颗粒栓塞子宫肌瘤的临床研究

目的评价碘油平阳霉素乳剂和聚乙烯醇颗粒（PVA）栓塞子宫肌瘤的疗效及安全性。方法回顾分析73例经碘油平阳霉素乳剂或PVA治疗的子宫肌瘤患者的资料,分成两组进行比较,其中A组（29例）采用碘油平阳霉素乳剂作为栓塞剂,B组（44例）采用PVA（直径300～700μm）作为栓塞剂,观察手术并发症,比较术前及术后6个月的子宫体积、肌瘤体积及性激素变化情况。结果A、B两组插管栓塞成功率100%,术后子宫及肌瘤体积均明显缩小,两组比较差异无统计学意义（P〉0.05） 两组患者术后症状明显改善,栓塞前后性激素无明显变化,两组比较差异无统计学意义（P〉0.05） 无严重并发症。结论碘油平阳霉素乳剂与PVA是治疗子宫肌瘤的安全、有效的栓塞材料,但平阳霉素是化疗药物,为避免近、远期的潜在并发症,使用PVA作为栓塞剂更安全。     

Soft-tissue venous malformations in children: percutaneous sclerotherapy with Ethibloc

Thirty-eight children with soft-tissue venous malformations (VMs) were treated with percutaneous injection of a new fibrosing agent (Ethibloc). The technique, results, side effects, and complications are detailed. Direct puncture of the VM allows evaluation of the draining venous system and direct injection of Ethibloc. This procedure alone or associated with surgery led to achievement of good or excellent results in 74% of the cases (complete cure in 50%), with minimal side effects and no major complications.     

MR Features of Juxta-Articular Venous Malformations of the Knee to Predict the Clinical Outcome of Sclerotherapy

PurposeTo analyze and correlate preinterventional magnetic resonance (MR) imaging findings with clinical symptoms after percutaneous sclerotherapy of venous malformations (VMs) adjacent to the knee.Materials and MethodsTwenty-five patients (mean age, 24 y; range, 7–55 y; 11 female) with 26 VMs adjacent to the knee undergoing sclerotherapy (direct puncture, diagnostic angiography, sclerosant injection) were identified, and MR imaging findings were analyzed. The VM involved the synovium of the knee joint in 19 of 26 cases (76%). These lesions were associated with joint effusion (3 of 19; 16%), hemarthrosis (4 of 19; 21%), or synovial thickening (16 of 19; 84%). Follow-up ended 6–8 weeks after the first or second sclerotherapy session if complete pain relief was achieved or 3 months after the third sclerotherapy session. Treatment outcomes were categorized as symptom improvement (complete or partial pain relief) or poor response (unchanged or increased pain).ResultsForty-nine percutaneous sclerotherapy sessions were performed. Despite the absence of signs of knee osteoarthritis, patients with a VM involving the synovium (8 of 14; 57%) showed a poor response to sclerotherapy (1 of 8 [13%] pain-free after 1 sclerotherapy session). Among patients with VMs with no associated joint alteration and no synovial involvement (6 of 14; 43%), 5 of 6 (83%) showed improvement of symptoms after 1 sclerotherapy session (P < .05).ConclusionsJuxta-articular VMs of the knee are frequently associated with hemarthrosis and synovial thickening. Patients with signs of osteoarthritis and synovial involvement of the VM on presclerotherapy MR imaging deserve special consideration, as these findings predict worse clinical symptoms after sclerotherapy.     

平阳霉素碘油乳剂动脉灌注在富血性肿瘤介入治疗中的应用

目的 评价平阳霉素碘油乳剂（ｐｉｎｇｙａｎｇｍｙｃｉｎ－ｌｉｐｉｏｄｏｌ ｅｍｕｌｓｉｏｎ,ＰＬＥ）动脉灌注治疗富血性良恶性肿瘤的疗效和安全性。方法 对８０例良性肿瘤经动脉灌注ＰＬＥ,随访２～１２个月观察疗效及并发症。结果 除１例上肢血管瘤外,其余肿瘤血管床灌注后均有碘油沉积。颜面部、上肢、椎体血管瘤及子宫肌瘤临床症状明显改善。肝海绵状血管较均上或消失。肝癌患者ＤＳＡ造影见肿瘤血管变细或减少,肾癌     

双途径注药术治疗肝海绵状血管瘤的疗效评价

目的探讨经肝动脉栓塞结合经皮瘤体内直接注射治疗肝血管瘤的疗效和价值。资料与方法采用Seldinger技术行肝动脉插管至血管瘤供血动脉,对32例肝海绵状血管瘤注入平阳霉素碘油乳剂(PLE)至血管瘤体大部分充填,用明胶海绵颗粒栓塞供血动脉;对碘油空虚区域再行经皮瘤体内直接注射PLE。定期观察瘤体碘油充填情况,瘤体大小和并发症。结果经肝动脉栓塞结合经皮瘤体内直接注射治疗肝血管瘤后,碘油沉积好,血管瘤体积明显缩小,无严重并发症。结论经肝动脉栓塞结合经皮瘤体内直接注射治疗肝血管瘤具有疗效好,并发症少等优点。     

Klippel-Trenaunay综合征的动脉造影表现和介入治疗

目的 观察K1ippel-TrenaunTdy综合征(KTS)的动脉造影表现并采用新的介入方法对其进行治疗。方法 观察7例KTS患肢动脉DSA的影像表现。采用经导管患肢动脉内注射平阳霉素碘油乳剂(PLE,平阳霉素用量6-12 mg,超乳化碘油4-8 m1)治疗。观察术后疗效、副反应和并发症。结果 动脉造影显示患肢少数动脉2、3级分支增粗,软组织内可见部分斑片状染色伴大小不等血窦显影(5例),引流静脉增粗(4例)和浅静脉迂曲扩张(5例)。病变区碘油沉积良好者6例,1例碘油沉积欠佳。术后随访13-30个月,肢体肥大明显回缩者6例,大腿的周长接近正常肢体,1例病情无明显变化。1例于1年后局部轻度复发。主要术后反应:均有肢体中至重度肿胀和轻度发热,另外有一过性血清转氨酶升高2例和肢端麻木1例。并发症为局限性皮肤坏死1例,经治疗痊愈;另1例出现患侧足拇指背屈无力,治疗无效。结论 患肢动脉造影可以显示KTS部分畸形血管。PLE动脉内灌注治疗KTS引起的患肢肥大具有较好疗效。由于本疗法可能有较严重的副反应和并发症,应慎用。     

Cryoablation of Venous Malformations: A Systematic Review

This study aimed to review systematically the efficacy, safety, and technical aspects of cryoablation in the treatment of venous malformations (VMs) and to provide the groundwork for future studies. A literature search for clinical studies utilizing percutaneous cryoablation of VMs was performed. All clinical studies related to primary or secondary treatment of VMs with percutaneous cryoablation were included in this review. These selected studies were evaluated for patient characteristics, cryoablation technique, technical success, lesion size and pain scores before and after cryoablation, and adverse outcomes. Random effects analysis of postprocedural changes in lesion volume and pain scores was performed. There were 54 patients with 55 cases of cryoablation of VMs. Of these cases, 27 recorded changes in lesion volume and 31 recorded changes in pain scores. The weighted mean postprocedural decrease in lesion size was 92.0% (raw average, 71.7%). The weighted mean reduction in pain score was 77% (raw average, 78.2%). Considering all treated cases (55), complete resolution of symptoms was seen in 35 cases (63.6%) and overall (complete or partial) improvement in 52 cases (94.5%). Common postprocedural symptoms included pain, bruising, swelling and numbness lasting less than 2 weeks. There were two major adverse events (3.7%), with both cases due to persistent dysesthesia. Patients with a history of prior sclerotherapy demonstrated lower preprocedural and postprocedural pain scores (4.7 and 1.3) than patients without prior treatments (5.8 and 2.8). Cryoablation of VMs appears to be potentially safe and effective on limited short-interval follow-up.     

Protein-losing enteropathy: diagnosis with (99m)Tc-labeled human serum albumin scintigraphy

PURPOSE: To investigate the diagnostic value of technetium 99m-labeled human serum albumin (HSA) scintigraphy in a group of patients suspected of having protein-losing enteropathy (PLE). MATERIALS AND METHODS: After intravenous injection of 740 MBq of freshly prepared (99m)Tc HSA, serial images of the abdomen were obtained from 10 minutes until 24 hours after injection. A (99m)Tc HSA scan was considered positive for PLE if there was visible tracer exudation in the gut. The diagnosis was established on the basis of standard clinical and biopsy findings. RESULTS: Thirty-nine scans were obtained: 27 scans in 26 suspected cases of PLE and 12 scans in control subjects with no known gastrointestinal disease. Twenty-five of the 26 studies in patients suspected of having PLE showed (99m)Tc HSA activity in the bowel. Among the 25 studies with positive findings, seven demonstrated PLE only on images obtained 24 hours after injection. In the control subjects, no activity was seen in the bowel. CONCLUSION: (99m)Tc HSA with serial scanning for up to 24 hours is reliable and useful for imaging PLE. Sites of protein loss may also be demonstrated. This imaging method is convenient, easy to perform, and yields results within 24 hours.