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1.
AIM: The aim was to evaluate laser photocoagulation and the use of the Bonopty needle system in the treatment of osteoid osteoma. MATERIALS AND METHODS: Five patients with osteoid osteomas were treated with computed tomography (CT)-guided, percutaneous laser photocoagulation using the Bonopty biopsy system. RESULTS: Complete pain relief was obtained in four patients. In one patient, pain persisted until the 6 weeks follow-up but resolved within 24 h of repeating the procedure. There were no complications, and patients remained symptom free at follow-up of 4-23 months (mean, 14 months). CONCLUSION: CT-guided laser photocoagulation of osteoid osteoma is a minimally invasive technique that represents a cost-effective alternative to surgical excision. The Bonopty needle system allows successful penetration of the sclerotic bone surrounding the nidus with manual pressure alone. 相似文献
2.
MR imaging-guided laser ablation of osteoid osteomas with use of optical instrument guidance at 0.23 T 总被引:4,自引:2,他引:2
Sequeiros RB Hyvönen P Sequeiros AB Jyrkinen L Ojala R Klemola R Vaara T Tervonen O 《European radiology》2003,13(10):2309-2314
The purpose of this study was to determine the feasibility and features of low-field MR imaging in performing interstitial
laser ablation of osteoid osteomas. Between September 2001 and April 2002, five consecutive patients with clinical and imaging
findings suggesting osteoid osteoma and referred for removal of osteoid osteoma were treated with interstitial laser treatment.
A low-field open-configuration MRI scanner (0.23 T, Outlook Proview, Philips Medical Systems, Finland) with optical instrument
guidance hardware and software was used. Laser device used was of ND-Yag type (Fibertom medilas, Dornier Medizin Technik,
Germany). A bare laser fiber (Dornier Medizin Technik, Germany) with a diameter of 400 μm was used. Completely balanced steady-state
(CBASS; true fast imaging with steady precession) imaging was used for lesion localization, instrument guidance, and thermal
monitoring. A 14-G (Cook Medical, USA) bone biopsy drill was used for initial approach. Laser treatment was conducted through
the biopsy canal. All the lesions were successfully localized, targeted, and treated under MRI guidance. All the patients
were symptom free 3 weeks and 3 months after the treatment. There was one recurrence reported during follow-up (6 months).
The MRI-guided percutaneous interstitial laser ablation of osteoid osteomas seems to be a feasible treatment mode. 相似文献
3.
CT-guided percutaneous laser photocoagulation of osteoid osteomas of the hands and feet 总被引:1,自引:0,他引:1
Percutaneous local ablation of osteoid osteoma has largely replaced surgery, except in the small bones of the hands and feet.
The objective of this study was to describe the technical specificities and results of computed tomography (CT)-guided percutaneous
laser photocoagulation in 15 patients with osteoid osteomas of the hands and feet. We retrospectively examined the medical
charts of the 15 patients who were treated with CT-guided percutaneous laser photocoagulation therapy at our institution between
1994 and 2004. The 15 patients had a mean age of 24.33 years. None of them had received any prior surgical or percutaneous
treatment for the osteoid osteoma. The follow-up period was 24 to 96 months (mean, 49.93). The pain resolved completely within
1 week. Fourteen patients remained symptom-free throughout the follow-up period; the remaining patient experienced a recurrence
of pain after 24 months, underwent a second laser photocoagulation procedure, and was symptom-free at last follow-up 45 months
later. No adverse events related to the procedure or to the location of the tumor in the hand or the foot were recorded. CT-guided
percutaneous laser photocoagulation is an alternative to surgery for the treatment of osteoid osteomas of the hands and feet. 相似文献
4.
Percutaneous removal of osteoid osteomas using CT control 总被引:2,自引:0,他引:2
A method is described whereby an osteoid osteoma may be conveniently removed on an outpatient basis, using a bone biopsy drill and CT control. 相似文献
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Five cases of clinically suspected osteoid osteomas were studied by preoperative injection of technetium-99m methylene disphosphonate, intraoperative localization with a radiation-sensitive scintillation probe, and postoperative examination of the entire tissue specimen (including the presumed nidus and surrounding bone). Microradiography and light microscopy were also used. In addition, a new autoradiography technique was introduced in which the excised surgical specimen was placed on undeveloped x-ray film for pathologic localization, diagnosis of the lesions, and a study of the relative intensity of radioactive uptake in the nidus vs. surrounding bone. Autoradiography revealed that the nidus showed the greatest concentration of radioactivity, followed by the surrounding bone. The authors conclude that 99mTc can be used clinically in localizing osteoid osteomas and that preoperative and intraoperative scanning can assist in conservative surgical excision, e.g., minimal extirpation of bone in delicate areas such as the spine. For small lesions, autoradiography assists the pathologist in identifying an osteoid osteoma. 相似文献
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8.
Computed tomography of axial skeletal osteoid osteomas 总被引:3,自引:0,他引:3
J L Gamba S Martinez J Apple J M Harrelson J A Nunley 《AJR. American journal of roentgenology》1984,142(4):769-772
The CT features of a case of adult ileocolic intussusception and of experimentally induced ileocolic, cecocolic, and colocolic intussusceptions are presented. Both the clinical and experimental cases demonstrated (1) "target" masses with enveloped, eccentrically located areas of low density and (2) interspersed low- and high-density stripes within the intussusception producing a "layered" or "stratified" pattern. This layered pattern of abdominal masses may be characteristic of intussusceptions regardless of location. 相似文献
9.
L G Morassi K Kokkinis D S Evangelopoulos O Karargyris I Vlachou K Kalokairinou S G Pneumaticos 《The British journal of radiology》2014,87(1038)
Objective:
Osteoid osteoma (OO) accounts for approximately 10–12% of all benign bone tumours and 3% of all bone tumours. Spinal involvement appears in 10–25% of all cases. The purpose of this study was to evaluate the safety and efficacy of CT-guided radiofrequency (RF) ablation in the treatment of spinal OOs and report our experience.Methods:
13 patients suffering from spinal OO and treated at the authors'' institution using CT-guided RF ablation were retrospectively evaluated. The RF probe was introduced through a 11-G Jamshidi® needle, and the lesion was heated at 90 °C for 6 min.Results:
All procedures were considered technically successful as the correct positioning of the probe was proven by CT. 11 of the 13 patients reported pain relief after RF ablation. In two cases, RF ablation was repeated 1 month after the first procedure. Pain relief was achieved in both cases after the second procedure. No recurrence was reported throughout the follow-up. No complications like skin burn, soft-tissue haematoma, infection, vessel damage or neurological deficit were reported.Conclusion:
This study demonstrates that CT-guided percutaneous RF ablation is a safe and effective method for the treatment of spinal OOs.Advances in knowledge:
The data of this study support the efficacy and safety of the recently applied CT-guided percutaneous RF ablation technique for the treatment of spinal OOs.Osteoid osteoma (OO) represents a benign bone tumour first described by Jaffe1 in 1935. The lesion accounts for approximately 10–12% of all benign bone tumours and 3% of all bone tumours. It is characterized by a nidus, consisting of osteoid, osteoblasts and fibrovascular stroma, surrounded by sclerotic bone usually measuring <1.5 cm in diameter. OOs are characteristically seen in children and young adults with a predilection for long bones, particularly in lower extremities.2 Spinal involvement usually affecting the posterior elements appears in 10–25% of all cases.3,4 The typical symptom is localized pain typically worsening at night, ameliorated by the administration of salicylates (acetylsalicylic acid) or non-steroidal anti-inflammatory drugs (NSAIDs). In spinal cases of OO, radiation of pain distally to the lesion site might simulate radiculopathy similar to disc herniation especially if the lesion is located close to a nerve root. Painful antalgic scoliosis is frequent in thoracolumbar lesions in children and adolescents.5,6 Spinal lesions are usually difficult to diagnose, and the reported delay from presentation to final diagnosis and treatment can be as long as 24 months in some cases.7–9 Neurologic deficit does not generally appear.In the past, conventional surgical excision and more recently minimally invasive surgery techniques were the treatment of choice in cases of spinal OOs when conservative treatment with anti-inflammatory and salicylates fails or is contraindicated.10–15Rosenthal et al16 first introduced percutaneous radiofrequency (RF) ablation for the treatment of OOs. The effectiveness of RF ablation of OOs localized in the extremities and pelvis has been proven by many studies.16–19Percutaneous RF ablation for the treatment of spinal OOs is not widely used, probably owing to the potential danger to the adjacent neural and vascular elements. In recent years, however, some clinical studies reported good results in the management of spinal OOs using CT-guided RF ablation.8,20–23The purpose of this study was to evaluate the safety and efficacy of CT-guided RF ablation in the treatment of spinal OOs and report our experience. 相似文献10.
M. Wioland A. Sergent-Alaoui 《European journal of nuclear medicine and molecular imaging》1996,23(8):1003-1011
The complete removal of a lesion which resembles, or is covered by adjacent tissue may be difficult. Therefore, the capacity of certain lesions to specifically concentrate a radiopharmaceutical has been used to orient progress during surgery. Usually, the measurements of radioactivity in the operative field are carried out by means of small, handy radiation-detecting probes which can be sterilized. Intra-operative nuclear medicine or radionuclide-guided surgery has steadily gained in importance. However, this technique is not being taught. Our study, based on radionuclide-guided surgery of 175 orthopaedic patients suspected of having osteoid osteoma, is well suited to teach the particularities of intra-operative radiation detection, as well as the collaboration between the nuclear physician and the surgeon in the operating theatre.Part of this work was carried out when M.W. and A. S.-A. were at the Saint-Antoine (Paris) and Henri Mondor (Créteil) hospitals respectively. 相似文献
11.
Six cases of suspected osteoid osteoma of tubular bones were evaluated by computed tomography (CT). In all cases a radiolucent nidus was clearly demonstrated. In two cases a radiodense center of the nidus was visualized. It is suggested that CT may replace conventional tomography in the evaluation of these lesions. Due to its ability to locate the lesion in the transverse plane, CT is superior for the exact planning of surgery to avoid unnecessary large or misdirected resections. Adequate window settings are essential in the evaluation of these lesions. 相似文献
12.
C Poey J L Clement C Baunin J Assoun C Puget-Mechinaud J Giron H Joomye M P Chicoisne P Bonnevialle J J Railhac 《Journal of computer assisted tomography》1991,15(6):1056-1058
We report one case of percutaneous extraction of an osteoid osteoma of the lumbar spine under CT guidance. We describe the procedure of nidus extraction. This technique allows precise removal of the nidus with pathologic verification after extraction. 相似文献
13.
Florian Streitparth Ulf Teichgräber Thula Walter Klaus Dieter Schaser Bernhard Gebauer 《Skeletal radiology》2010,39(11):1131-1137
Thermal ablation has become a therapy of choice in the treatment of osteoid osteomas. To date, computed tomography has been
the standard imaging modality for minimally invasive treatment regimes. We report a case of a 46-year-old man with a recurrent
osteoid osteoma in the right tibial head after CT-guided drill excision and repeat treatment with laser ablation under open
high-field MRI guidance. We describe the steps of the interventional MRI procedure and discuss related innovative guidance
and monitoring features, and potential benefits of MRI compared with CT-guided techniques. In conclusion, MR-guided laser
ablation was proved to be safe and effective. 相似文献
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15.
Cribb GL Goude WH Cool P Tins B Cassar-Pullicino VN Mangham DC 《Skeletal radiology》2005,34(11):702-706
Objective To examine factors which affect local recurrence of osteoid osteomas treated with percutaneous CT-guided radiofrequency thermocoagulation.Design and patients A prospective study was carried out on 45 patients with osteoid osteoma who underwent percutaneous radiofrequency thermocoagulation with a minimum follow-up of 12 monthsResults There were seven local recurrences (16%); all occurred within the first year. Local recurrence was significantly related to a non-diaphyseal location (P<0.01). There was no significant relationship (P=0.05) between local recurrence and age of the patient, duration of symptoms, previous treatment, size of the lesion, positive biopsy, radiofrequency generator used or the number of needle positions. There were no complications.Conclusions Osteoid osteomas in a non-diaphyseal location are statistically more likely to recur than those in a diaphyseal location when treated with CT-guided percutaneous radiofrequency thermocoagulation. This relationship between local recurrence and location has not been previously reported. 相似文献
16.
Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. 总被引:22,自引:0,他引:22
Osteoid osteoma is a benign, self-limited tumor of bone that usually requires surgical excision for relief of pain and to prevent long-term consequences. Radio-frequency electrodes have been successfully and safely used to ablate small areas of the central nervous system and to perform ablation elsewhere in the body. The authors have used this technique in four patients with proved or presumptive osteoid osteoma, completely relieving the symptoms in three. 相似文献
17.
Here we report our experience of a neuroprotective adaptation of the technique of CT-guided radiofrequency (RF) ablation of
spinal osteoid osteomas. Over 9 years seven patients underwent eight CT-guided RF treatments for osteoid osteoma. CT-guided
RF ablation was performed with general anaesthesia. The lesion was heated to 90°C for 2 min for two cycles by using a Cosman
SMK TC-10 RF electrode. This was preceded by a bolus of room temperature sterile water (10 ml) injected through a 26G curved
spinal needle into the exit foramen and adjacent epidural space for neuroprotection. The age of the patient, sex, lesion location,
biopsy results and complications were recorded. All the biopsies (n = 7) demonstrated histological features of osteoid osteoma. All the procedures were technically successful. Clinical success
was assessed up to 3 years post procedure. There was an 85% clinical success rate (6 of the 7 patients), with recurrence of
a lesion at 6 months, necessitating a repeat procedure (successful). CT-guided percutaneous RF ablation of spinal osteoid
osteoma preceded by bolus of sterile water, injected through a spinal needle into the exit foramen and adjacent epidural space
for neuroprotection, is a safe and effective procedure. 相似文献
18.
Aschero A Gorincour G Glard Y Desvignes C Paris M Bourlière-Najean B Bollini G Petit P 《European radiology》2009,19(3):679-686
To evaluate the efficiency of laser thermocoagulation under computed tomography (CT) guidance in the treatment of osteoid
osteoma within a strictly pediatric group. Twenty-five patients aged 4 to 17 years were treated under CT by laser thermocoagulation.
The nidus measured on average 10.1 mm. Pain relief was the main item for evaluation of the effectiveness of our treatment.
Follow-up ranged from 3 months to 61 months (mean, 26 months). Technical success was achieved in 100%. Thermocoagulation proved
to be initially effective in 24 of 25 children (96%) and had a positive long-term effect in 23 of 25 children (92%). We had
four minor complications and one severe complication (partial osteonecrosis of the talus). Laser thermocoagualation is an
effective treatment for osteoid osteoma in pediatric patients. 相似文献
19.