PURPOSE To retrospectively assess the technical feasibility, safety and clinical efficacy of percutaneous MR-guided cryoablation of low-flow vascular malformations (LFVM). MATERIALS AND METHODS Between July 2013 and May 2019, 9 consecutive patients (5 male; 4 female; mean age 39.4 ± 15.3 years, range 15-68) underwent MR-guided cryoablation of LFVM. Patients were treated due to pain in all cases. Procedural data, complications and clinical results were analyzed. RESULTS Technical success defined as complete coverage of the LFVM by the iceball without involvement of nearby non-target thermal-sensitive structures was achieved in 9/9 (100%) cases. Mean procedure time was 122 ± 20 min (range 90-150); 2-6 cryoprobes (mean 3.7 ± 1.2) and 2-4 freezing cycles (mean freezing time 19.8 ± 11.8 min; range 4-40) were applied. No complications were noted. Mean time from the first treatment to the last follow-up was 548 days (range 30-1776). Persistent/recurring pain was noted in 3/9 cases (33%) 30, 133 and 639 days after cryoablation, respectively, and was related in all cases to MR-confirmed local residual/recurring disease. A second cryoablation treatment was performed in these 3 cases with complete pain control at the last available follow-up (153, 25, 91 days, respectively). In the whole population, at mean 161 days (range 25-413) after the last treatment, on the numerical pain rate scale, pain significantly dropped from mean 6.4 ± 2.1 (range 3-9/10) before CA to mean 0.3 ± 0.9 (range 0-3/10) after (p = 0.009). CONCLUSIONS Percutaneous MR-guided cryoablation is technically feasible, safe and effective for the treatment of symptomatic LFVM. LEVEL OF EVIDENCE Level 3b, retrospective cohort study.

中文翻译：

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低流量血管畸形的经皮MR引导低温消融：技术可行性，安全性和临床疗效。

目的回顾性评估经皮MR引导的低流量血管畸形（LFVM）冷冻消融术的技术可行性，安全性和临床疗效。材料与方法在2013年7月至2019年5月之间，连续9例患者（男5例；女4例；平均年龄39.4±15.3岁，范围15-68）接受了MR引导的LFVM冷冻消融术。在所有情况下均因疼痛接受了治疗。分析了手术数据，并发症和临床结果。结果在9/9（100％）的情况下，技术成功定义为冰球完全覆盖了LFVM，而没有附近的非目标热敏结构的参与。平均手术时间为122±20分钟（范围90-150）；进行2-6次冷冻（平均3.7±1.2）和2-4次冷冻（平均冷冻时间19.8±11.8分钟；范围4-40）。没有发现并发症。从第一次治疗到最后一次随访的平均时间为548天（范围30-1776）。冷冻消融后30、133和639天分别有3/9例（33％）持续/复发性疼痛，并且在所有情况下均与MR确认的局部残留/复发性疾病有关。对这3例患者进行第二次冷冻消融治疗，并在最后一次随访（分别为153、25、91天）时完全控制疼痛。在整个人群中，在最后一次治疗后平均161天（范围25-413），在数字疼痛率量表上，疼痛从CA之前的平均6.4±2.1（范围3-9 / 10）显着降低到CA的平均值0.3±0.9 （p = 0.009）之后（0-3 / 10）。结论经皮MR引导下的冷冻消融术在治疗症状性LFVM方面在技术上是可行，安全且有效的。证据级别3b，