摘要
目的:探讨三维旋转DSA技术中DSA类CT成像技术在胸腰椎压缩性骨折经皮穿刺椎体成形术中的应用方法及其价值。方法:对18例椎体压缩性骨折患者行经皮穿刺椎体成形术,分别在穿刺针进入椎弓根后和骨水泥注射成形后使用血管机的3D-DSA程序进行摄影采集。然后采用DSA类CT成像程序分别观察穿刺针在椎体和椎弓根内的位置、骨水泥在椎体内的分布和椎体外泄漏情况等,并结合患者疼痛缓解的情况和并发症等进行对照分析。结果:所有患者穿刺针位置完全符合操作需要,椎体内骨水泥注射量3.5～9.0ml,椎体骨髓腔内骨水泥分布范围平均大于椎体体积的60%。较明显的椎体旁骨水泥泄漏3例,椎旁静脉泄漏2例,椎管内静脉泄漏1例,但均无神经压迫等并发症发生。术后1周的治疗有效率100%,优良率83%。结论:椎体成形时利用DSA类CT成像技术可以更直观地监测穿刺过程,准确评判骨水泥的分布和泄露情况,可及时明确治疗预后和处理并发症。
Objective：To study the clinical value of similar CT imaging in percutaneous vertebroplasty （PVP） for the treatment of vertebral body compression fracture. Methods：PVP was undertaken in 18 cases with vertebral body eompres sion fracture. After puncture of vertebral arch as well as vertebroplasty with bone cement injection was successfully performed,3D DSA technique and photography by an angiography equipment were undertaken in all patients. Similar CT ima ging was used to reveal the position of puncture needle within vertebral body and vertebral arch,distribution of bone cement within vertebral body as well as extra vertebral leakage of bone cement. The imaging findings and the remission of pain as well as associated complications were correlated and retrospectively analyzed. Results： The position of puncture needle was appropriate in all 18 cases. The amount of bone cement injected into the vertebral body was 3.5-9.0ml. The mean distribu tion area of injected bone cemenl was larger than 60% of the volume of vertebral body. There was obvious leakage of bone cement adjacenl to the vertebral body in 3 cases, para-vertebral vein leakage in 3 cases,and intra vertebral canal vein leakage in 1 case. No nerve compression or other complication occurred. The effective rate was 100% and the rate of excellence was 83 % after 1 week. Conclusions：The whole course of PVP can be monitored directly, the distribution of bone cement as well as existence of leakage can be accurately evaluated by similar CT imaging technique. Therefore, the prognosis after treatment can be accurately predicted and the complication can be timely managed.
出处
《放射学实践》
北大核心
2009年第11期1254-1257,共4页
Radiologic Practice
