A CT-free protocol to treat osteoid osteoma of the hip region in childhood and adolescence by percutaneous drilling and by hip arthroscopy

2021 ◽  
pp. 112070002199626
Author(s):  
Oliver Eberhardt ◽  
Thekla von Kalle ◽  
Rebecca Matthis ◽  
Richard Doepner ◽  
Thomas Wirth ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Hip Joint ◽  
Hip Arthroscopy ◽  
Standard Form ◽  
Childhood And Adolescence ◽  
Ct Guided ◽  
Contrast Enhanced ◽  
Mri Guided ◽  
Mri Diagnostics

Introduction: It is often difficult to clinically and radiologically diagnose intra-articular osteoid osteomas and osteoid osteomas of the hip joint. Treatment can also be difficult due to complex locational relationships. CT-guided radiofrequency ablation is currently the standard form of treatment. In this paper we report on a minimally-invasive concept for treating osteoid osteomas near the hip joint in children and adolescents which does not involve using computed tomography. Material and method: 10 patients with an average age of 12.1 years underwent treatment for osteoid osteomas in the hip joint region. The diagnosis was made using a contrast-enhanced MRI. The osteoid osteomas were marked percutaneously using x-ray and MRI guidance. MRI-guided drilling/curettage was performed in 4 cases and arthroscopic resection in 6 cases. Results: All lesions were successfully treated using the MRI-guided method. All patients were free of pain after the treatment. There was no instance of recurrence during the follow-up period, which averaged 10 months. The effective dose for marking the lesion was between 0.0186 mSv and 0.342 mSV (mean 0.084 mSV). Conclusions: Our MRI diagnostics protocol, the MRI-guided drilling and the minimally invasive hip arthroscopy represent an alternative to CT-guided radiofrequency ablation in the treatment of osteoid osteomas. Radiation exposure can thereby be significantly reduced. Hip arthroscopy can also be used to treat secondary pathologies such as femoroacetabular impingement.

Awake CT-guided percutaneous stylomastoid foramen puncture and radiofrequency ablation of facial nerve for treatment of hemifacial spasm

2021 ◽  
pp. 1-7
Author(s):  
Bing Huang ◽  
Ming Yao ◽  
QiLiang Chen ◽  
Huidan Lin ◽  
Xindan Du ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Ct Guided ◽  
Stylomastoid Foramen ◽  
History Of ◽  
First Time

OBJECTIVE Hemifacial spasm (HFS) is a debilitating neuromuscular disorder with limited treatment options. The current study describes a novel minimally invasive procedure that provided effective and sustained relief for patients with HFS. The authors provide a detailed description of the awake CT-guided percutaneous radiofrequency ablation (RFA) of the facial nerve for treatment of HFS, and they examine its clinical efficacy. This is the first time in the literature that this procedure has been applied and systematically analyzed for HFS. METHODS Patients with a history of HFS were recruited between August 2018 and April 2020. Those with a history of cerebellopontine lesions, coagulopathy, ongoing pregnancy, cardiac pacemaker or defibrillator implants, or who declined the procedure were excluded from the study. Fifty-three patients who met the study criteria were included and underwent awake CT-guided RFA. Under minimal sedation, a radiofrequency (RF) needle was used to reach the stylomastoid foramen on the affected side under CT guidance, and the facial nerve was localized using a low-frequency stimulation current. Patients were instructed to engage facial muscles as a proxy for motor monitoring during RFA. Ablation stopped when the patients’ hemifacial contracture resolved. Patients were kept for inpatient monitoring for 24 hours postoperatively and were followed up monthly to monitor resolution of HFS and complications for up to 19 months. RESULTS The average duration of the procedure was 32–34 minutes. Postoperatively, 91% of the patients (48/53) had complete resolution of HFS, whereas the remaining individuals had partial resolution. A total of 48 patients reported mild to moderate facial paralysis immediately post-RFA, but most resolved within 1 month. No other significant complication was observed during the study period. By the end of the study period, 5 patients had recurrence of mild HFS symptoms, whereas only 2 patients reported dissatisfaction with the treatment results. CONCLUSIONS The authors report for the first time that awake CT-guided RFA of the facial nerve at the stylomastoid foramen is a minimally invasive procedure and can be an effective treatment option for HFS.

scholarly journals Two Cases of Strictures after Percutaneous CT-Guided Radiofrequency Ablation for Renal Cell Carcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ortwin Heißler ◽  
Stephan Seklehner ◽  
Maximilian Fingernagel ◽  
Paul F. Engelhardt ◽  
Claus Riedl
Keyword(s):  
Renal Cell Carcinoma ◽  
Urinary Tract ◽  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Complication Rate ◽  
Thermal Injury ◽  
Upper Urinary Tract ◽  
Percutaneous Radiofrequency Ablation ◽  
Invasive Treatment ◽  
Ct Guided

Percutaneous radiofrequency ablation is a safe and effective minimally invasive treatment option in selected patients with T1a tumors of the kidney with a low complication rate. We describe two cases that developed the rare but severe complication of thermal injury-induced strictures of the upper urinary tract and its consecutive management.

Morphologic Change in Computed Tomography of Aldosterone-Producing Adenoma after Radiofrequency Ablation

2014 ◽  
Vol 65 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Ryan K.L. Lee ◽  
Shirley Y.W. Liu ◽  
Cina S.L. Tong ◽  
Paul S.F. Lee ◽  
Enders K.W. Ng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiofrequency Ablation ◽  
Tumour Size ◽  
Tumour Volume ◽  
Morphologic Change ◽  
Residual Tumour ◽  
Ct Guided ◽  
Contrast Enhanced ◽  
Before And After ◽  
Aldosterone Producing Adenoma

Objective To evaluate the morphologic changes of aldosterone-producing adenoma (APA) on computed tomography (CT) before and after radiofrequency ablation (RFA) and to assess the factors that are important in determining successful complete ablation of these tumours. Method Between August 2004 and August 2011, 24 consecutive patients with APA undergoing CT-guided percutaneous RFA were identified from our prospective database. The pre-RFA and post-RFA CT appearances of these APAs that showed positive biochemical response were reviewed retrospectively for their 3-dimensional size, tumour volume, and CT attenuation in terms of Hounsfield units (HU). A comparison of these parameters before and after RFA was performed. Results In this study, there were 23 APAs in these 24 patients that showed biochemical cure of primary aldosteronism after RFA. When comparing post-RFA to pre-RFA CTs, there was no significant change in tumour size (14.5 mm vs 14.6 mm: P = .83) and tumour volume (1.55 cm3 vs 1.59 cm3; P = .41) after RFA. In nonenhanced CT images, there was no significant reduction in HU from pre-RFA to post-RFA measurements (4.4 HU vs 7.9 HU; P = .52). In contrast-enhanced CTs, there was a significant drop in HU after RFA (from 48.3 HU to 14.7 HU; P = .03). None of the included cases showed a focal region of contrast enhancement to suggest residual tumour. Conclusion A change in tumour size, tumour volume, and HU in nonenhanced CT were unreliable in defining radiologic treatment success. Only changes in HU in contrast-enhanced CT was useful in confirming a positive treatment response after RFA for APA.

MRI-guided radiofrequency ablation of liver tumours: A valuable and minimally-invasive therapeutic option

1998 ◽  
Vol 7 (6) ◽  
pp. 533-539 ◽  
Author(s):  
J. Trübenbach ◽  
P. L. Pereira ◽  
F. Schick ◽  
C. D. Claussen ◽  
P. E. Huppert
Keyword(s):  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Therapeutic Option ◽  
Liver Tumours ◽  
Mri Guided

scholarly journals History of hip arthroscopy

2020 ◽  
Vol 1 ◽  
pp. 73-80
Author(s):  
Shivani Shukla ◽  
Matthew Pettit ◽  
Karadi Hari Sunil Kumar ◽  
Vikas Khanduja
Keyword(s):  
Minimally Invasive ◽  
Hip Joint ◽  
Hip Arthroscopy ◽  
Diagnostic Procedure ◽  
Therapeutic Procedure ◽  
Current State ◽  
Significant Step ◽  
History Of ◽  
Articular Pathology ◽  
The Way

Hip arthroscopy is a minimally invasive therapeutic and diagnostic procedure appropriate for an evolving list of conditions. It is routinely used for the treatment of intra- and extra-articular pathology of the hip joint. The development of endoscopy paved the way for the development of arthroscopy. Hip arthroscopy was first described in 1931 by Michael Burman, and its widespread adoption was only achieved some 60 years later during the 1990s. Dr. Watanabe, from Japan, has been credited with the development of modern arthroscopy for his work in developing a practical arthroscope and advancement of both explorative arthroscopy and surgical arthroscopic techniques. More recently, the use of distraction proved as a significant step in the utility of hip arthroscopy and paved the way for future innovations in the procedure. The authors provide a brief overview of the history hip arthroscopy, relevant developments which have paved the way for this procedure and the current state of arthroscopy as a diagnostic and therapeutic procedure.

1929: Contrast Enhanced Ultrasound Monitoring of Radiofrequency Ablation

2004 ◽  
Vol 171 (4S) ◽  
pp. 509-510
Author(s):  
D Brooke Johnson ◽  
David A. Duchene ◽  
Grant D. Taylor ◽  
Jeffrey A. Cadeddu
Keyword(s):  
Radiofrequency Ablation ◽  
Contrast Enhanced Ultrasound ◽  
Ultrasound Monitoring ◽  
Contrast Enhanced

Myoglobinemia After CT-Guided Radiofrequency Ablation of a Hepatic Metastasis

2002 ◽  
Vol 178 (2) ◽  
pp. 359-361 ◽  
Author(s):  
Sridhar Shankar ◽  
Kemal Tuncali ◽  
Eric vanSonnenberg ◽  
Julian L. Seifter ◽  
Stuart G. Silverman
Keyword(s):  
Radiofrequency Ablation ◽  
Hepatic Metastasis ◽  
Ct Guided

scholarly journals Contrast-Enhanced Ultrasound Imaging of Uterine Disorders: A Systematic Review

2021 ◽  
pp. 016173462110174
Author(s):  
Barbara Stoelinga ◽  
Lynda Juffermans ◽  
Anniek Dooper ◽  
Marleen de Lange ◽  
Wouter Hehenkamp ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Myometrial Invasion ◽  
Diagnostic Technique ◽  
Specific Information ◽  
Full Potential ◽  
Contrast Enhanced Ultrasound ◽  
Literature Overview ◽  
Benign Tissue ◽  
Contrast Enhanced ◽  
Endometrial Carcinomas

Uterine disorders are often presented with overlapping symptoms. The microvasculature holds specific information important for diagnosing uterine disorders. Conventional sonography is an established diagnostic technique in gynecology, but is limited by its inability to image the microvasculature. Contrast-enhanced ultrasound (CEUS), is capable of imaging the microvasculature by means of intravascular contrast agents; that is, gas-filled microbubbles. We provide a literature overview on the use of CEUS in diagnosing myometrial and endometrial disorders, that is, fibroids, adenomyosis, leiomyosarcomas and endometrial carcinomas, as well as for monitoring and enhancing the effectiveness of minimally invasive therapies. A systematic literature search with quality assessment was performed until December 2020. In total 34 studies were included, published between 2007 and 2020.The results entail a description of contrast-enhancement patterns obtained from healthy tissue and from malignant and benign tissue; providing a first base for potential diagnostic differentiation in gynecology. In addition it is also possible to determine the degree of myometrial invasion in case of endometrial carcinoma using CEUS. The effectiveness of minimally invasive therapies for uterine disorders can safely and accurately be assessed with CEUS. In conclusion, the abovementioned applications of CEUS are promising and it is worth further exploring its full potential for gynecology by designing innovative and methodologically high-quality clinical studies.

scholarly journals Application of Intraoperative CT-Guided Navigation in Simultaneous Minimally Invasive Anterior and Posterior Surgery for Infectious Spondylitis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Meng-Huang Wu ◽  
Navneet Kumar Dubey ◽  
Ching-Yu Lee ◽  
Yen-Yao Li ◽  
Chin-Chang Cheng ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screws ◽  
Ct Guided ◽  
Posterior Surgery ◽  
Intraoperative Computed Tomography ◽  
Reactive Protein ◽  
Angle Correction ◽  
Average Operative Time ◽  
Placement Accuracy ◽  
Infectious Spondylitis

This study was aimed at evaluating the safety and efficacy of using intraoperative computed tomography- (iCT-) guided navigation in simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. Nine patients with infectious spondylitis were enrolled in this study. The average operative time was 327.6 min (range, 210–490) and intraoperative blood loss was 407 cc (range, 50–1,200). The average duration of hospital stay was 48.9 days (range, 11–76). Out of a total of 54 pedicle screws employed, 53 screws (98.1%) were placed accurately. A reduced visual analog scale on back pain (from 8.2 to 2.2) and Oswestry disability index (from 67.1% to 25.6%) were found at the 2-year follow-up. All patients had achieved resolution of spinal infection with reduced average erythrocyte sedimentation rate (from 83.9 to 14.1 mm/hr) and average C-reactive protein (from 54.4 to 4.8 mg/dL). Average kyphotic angle correction was 10.5° (range, 8.4°–12.6°) postoperatively and 8.5° (range, 6.9°–10.1°) after 2 years. In conclusion, the current iCT-guided navigation approach has been demonstrated to be an alternative method during simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. It can provide a good intraoperative orientation and visualization of anatomic structures and also a high pedicle screw placement accuracy in patient’s lateral decubitus position.

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