| 蔡金辉,刘庆余,曾玉蓉,刘志锋,阮耀钦,郭栋华,王振.MRI预测经皮椎体强化术骨水泥椎间盘渗漏的价值[J].中国医学影像技术,2017,33(7):1061~1065 |
| MRI预测经皮椎体强化术骨水泥椎间盘渗漏的价值 |
| Value of MRI in predicting intradiscal cemment leakage during percutaneous vertebral augmentation |
| 投稿时间：2017-01-25 修订日期：2017-05-11 |
| DOI：10.13929/j.1003-3289.201701135 |
| 中文关键词: 骨质疏松 脊柱骨折 经皮椎体成形术 磁共振成像 |
| 英文关键词:Osteoporosis Spinal fracture Percutaneous vertebroplasty Magnetic resonance imaging |
| 基金项目:广东省科技计划项目（2014A020212426）、广州市科技计划项目（201510010087）、广州市增城区人民医院青年医学人才培育基金（2013-QN-005）。 |
|
| 摘要点击次数: 1813 |
| 全文下载次数: 1123 |
| 中文摘要: |
| 目的 探讨术前MRI预测经皮椎体强化术（PVA）中骨水泥椎间盘渗漏的临床价值。方法 回顾性分析经PVA治疗的127例骨质疏松性椎体压缩性骨折（OVCF）患者的临床及影像资料，比较患者年龄、性别、手术椎体部位、手术方式及术前MRI是否存在骨折椎体终板损伤、达终板骨折线、邻近椎间盘损伤及椎体裂隙时骨水泥椎间盘渗漏率的差异。结果 127例OVCF患者中，手术椎体179个，涉及358个终板及341个椎间盘。有终板损伤、达终板骨折线、邻近椎间盘损伤及椎体裂隙征象的骨水泥邻近椎间盘渗漏率分别为57.73%（56/97）、60.98%（25/41）、35.91%（51/142）、55.56%（20/36），均高于无上述征象椎体（P均<0.05）。经皮椎体后凸成形术（PKP）及经皮椎体成形术（PVP）患者椎体骨水泥椎间盘渗漏率分别为26.67%（16/60）、42.86%（51/119），两者差异具有统计学意义（P=0.035）。骨水泥注入量 ≤5 ml椎体骨水泥椎间盘渗漏率为31.19%（34/109），低于骨水泥注入量 >5 ml椎体。性别、年龄、手术椎体部位对邻近椎间盘骨水泥渗漏的影响无统计学意义（P>0.05）。结论 术前MRI能有效预测PVA术中骨水泥向邻近椎间盘渗漏，选择PKP及控制骨水泥注入量等方式可以降低骨水泥椎间盘渗漏的风险。 |
| 英文摘要: |
| Objective To assess the value of preoperative MRI in predicting the incidence of cement leakage into adjacent discs during percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fracture (OVCF). Methods Clinical and radiological characteristics of 127 patients who were treated with PVA for OVCF were analyzed retrospectively. The following clinical data of these patients were analyzed, including gender, age, location of treated vertebral body and surgical approach. The image features of endplate injury, fracture line extended to the endplate, adjacent intervertebral dick injury and intravertebral cleft were evaluated on the preoperative MRI. The incidence of cement leakage into the adjacent disc were compared for the above factors with statistical methods. Results Totally 127 patients were enrolled in our study, including 179 treated vertebral bodies, 358 endplates and 341 adjacent intervertebral discs. The incidence of intradiscal cement leakage was 57.73%(56/97) in endplate injury sign, 60.98%(25/41) in fracture line extended to endplate sign, 35.91%(51/142) in adjacent discs injury sign and 55.56%(20/36) in intravertebral cleft sign. The differences were statistically significant on preoperative MRI in patients with the above signs compared to those who had not (P<0.05). The incidence of intradiscal cement leakage in percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) were 26.67%(16/60) and 42.86%(51/119), respectively, which was significant different (P=0.035). For bone cement volume ≤ 5 ml vertebral bodies, the incidence of intradiscal cement leakage was 31.19%(34/109), lower than bone cement volume > 5 ml vertebral bodies (47.14% , P=0.031). There was no statistically significant association between intradiscal cement leakage and age, gender and location of treated vertebral body (P>0.05). Conclusion Preoperative MRI can predict the leakage of bone cement into adjacent discs effectively during PVA. The PKP and the lower volume of bone cement injection can reduce the risk of intradiscal cement leakage. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
