可透射线胶化乙醇经皮硬化治疗骨病变的系统综述
该系统综述纳入6项回顾性研究共55例患者56个骨病变119次手术，主要适应证为动脉瘤样骨囊肿（80%）和侵袭性椎体血管瘤（18%）。技术成功率达100%，影像学完全缓解率96%，疼痛完全缓解率64.3%，无重大不良事件。提示RGE硬化治疗对选择性良性骨病变安全有效，但证据限于小样本回顾性研究。
要点
- RGE硬化治疗骨病变技术成功率达100%，影像学完全缓解率96%。
- 主要适应证为动脉瘤样骨囊肿和侵袭性椎体血管瘤。
- 无CIRSE≥4级或CTCAE≥4级重大不良事件，仅1例SIR 3级椎体骨折。
诊断标准与关键数值
- 技术成功率100%（119次手术）。
- 疼痛结局（28例）：完全缓解64.3%（18/28），部分缓解32.1%（9/28），持续3.6%（1/28）。
- 影像学随访（50个病变）：完全缓解96%，部分缓解4%。
- 不良事件按CIRSE（≥4级）或CTCAE（≥4级）标准无重大事件报告；1例SIR 3级椎体骨折，与RGE因果关系未确认。
- 3.6%的病变需后续手术。
局限性
- 仅纳入6项回顾性研究，样本量小（55例患者）。
- 证据限于小样本回顾性系列，需前瞻性对照研究及更长随访。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
PURPOSE: To systematically review the available evidence on the feasibility, safety, and clinical effectiveness of percutaneous sclerotherapy using radiopaque gelified ethanol (RGE, Discogel®) for bone lesions.
METHODS: A systematic search of MEDLINE, Embase, Web of Science, and Cochrane CENTRAL was performed. Primary studies reporting clinical, technical, and safety outcomes following RGE sclerotherapy for bone lesions were included. Data on patient characteristics, lesion type, procedural details, and outcomes were extracted and synthesized descriptively.
RESULTS: Six retrospective studies involving 55 patients (mean age 22.2 ± 20.4 years; range 3-65; 26 females) with 56 lesions and 119 procedures were included (mean 2.16 procedures per patient). Aneurysmal bone cysts (80%) and aggressive vertebral hemangiomas (18%) were the main indications. Technical success was reported in 100% of procedures. Pain outcomes were available for 28 patients, with complete resolution in 64.3% (18/28), partial reduction in 32.1% (9/28), and persistence in 3.6% (1/28). Radiological follow-up (50 lesions) demonstrated complete response in 96% and partial response in 4%. No major adverse events were reported according to CIRSE (≥ 4) or CTCAE (≥ 4) criteria. One SIR grade 3 vertebral fracture occurred without confirmed causal association to RGE. Subsequent surgery was required in 3.6% of lesions.
CONCLUSION: Although limited to small retrospective series, current evidence suggests that RGE sclerotherapy is a safe and effective minimally invasive option for selected benign bone lesions. Prospective comparative studies with longer follow-up are warranted.
引用
- Grange S, Cifuentes LM, Grange R, et al. Gelified ethanol for percutaneous sclerotherapy of bone lesions: a systematic review of clinical applications and outcomes. Skeletal Radiol. 2026. PMID: 42174179. doi:10.1007/s00256-026-05258-4
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。