Predictive value of preoperative MRI for risk of bone cement leakage during percutaneous vertebral augmentation(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2018年第12期
- Page:
- 1436-1440
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Predictive value of preoperative MRI for risk of bone cement leakage during percutaneous vertebral augmentation
- Author(s):
- HUANG Peikai1; WU Qinfu2; LIU Hailong1; XIAO Mengqiang1; HUANG Lesheng1; LIU Tianzhu1
- 1. Department of Medical Imaging, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, Zhuhai 519000, China; 2. Department of Ultrasound, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, Zhuhai 519000, China
- Keywords:
- ; Keywords: percutaneous vertebral augmentation; bone cement; risk of leakage; magnetic resonance imaging; predictive value
- PACS:
- R445.2；R683.2
- DOI:
- DOI:10.3969/j.issn.1005-202X.2018.12.013
- Abstract:
- Abstract: Objective To explore the value of preoperative magnetic resonance imaging (MRI) to predict the risk of bone cement leakage in percutaneous vertebral augmentation (PVA). Methods A total of 60 patients (88 surgical vertebral bodies) with osteoporotic vertebral compression fractures admitted to Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine from May 2016 to May 2018 were treated with PVA. MRI was performed before operation and DR was performed after operation for reexamination. The rate of bone cement leakage was calculated. The influencing factors, including gender, age (≤70 years old, >70 years old), surgical methods ［percutaneous kyphoplasty (PKP), percutaneous vertebroplasty (PVP)］, vertebral body (thoracic vertebrae, thoracolumbar vertebrae, lumbar vertebrae), volume of bone cement injection ［(≤4 mL, >4 mL)］ and MRI signs (endplate damage, endplate fracture line, intervertebral disc injury, vertebral body fissure) were compared. The receiver operating characteristic curve (ROC) was used to analyze the predictive value of MRI signs for cement intervertebral disc leakage. Results The effects of gender, age, vertebral body and volume of bone cement injection on the rate of bone cement leakage were marginal, without statistical differences (P>0.05). The rate of bone cement leakage was 26.67% (16/60) in patients treated with PKP, lower than 50% (14/28) in patients receiving PVP, and the differences were statistical (P<0.05). Preoperative MRI examination showed that the incidences of bone cement leakage in vertebral body with MRI signs of vertebral endplate injury, vertebral fissure, disc injury, and endplate fracture line were 27.40%, 57.89%, 30.30% and 54.55%, respectively, which were higher than 14.73%, 27.54%, 15.22%, 27.27% in the vertebral body without the above signs, and the difference was statistically significant (P<0.05). The incidences of bone cement leakage in patients with any 2, 3 and 4 kinds of the above MRI signs were up to 43.59%, 56.00% and 100.00%, respectively. The sensitivity of combining any 2, 3 and 4 kinds of the MRI signs to predict bone cement leakage was 0.818, 0.727 and 0.727, respectively, and the specificity was 0.553, 0.763 and 1.000, respectively. Conclusion PKP, with a lower risk of bone cement leakage than PVP, is recommended for osteoporotic vertebral compression fractures. In addition, preoperative MRI can be used to predict the risk of bone cement leakage through MRI signs.
Last Update: 2018-12-26