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中华介入放射学电子杂志 ›› 2017, Vol. 05 ›› Issue (02) : 98 -101. doi: 10.3877/cma.j.issn.2095-5782.2017.02.010

所属专题： 文献；

非血管介入

C臂锥体束CT成像技术在经皮椎体成形术中的临床应用
王福安1, 黄文诺1, 吕朋华1, 王书祥1,†(), 孙陵1, 徐川1, 葛俊1   
  1. 1. 225001　江苏扬州，江苏省苏北人民医院（扬州大学临床医学院）介入放射科
  • 收稿日期:2017-02-01 出版日期:2017-05-01
  • 通信作者: 王书祥

The clinical application of Cone Beam CT imaging technology in percutaneous vertebral plasty

Fuan Wang1, Wennuo Huang1, Penghua Lyu1, Shuxiang Wang1,†(), Ling Sun1, Chuan Xu1, Jun Ge1   

  1. 1. Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province (Clinical Medical College of Yangzhou University), YangZhou 225001, China
  • Received:2017-02-01 Published:2017-05-01
  • Corresponding author: Shuxiang Wang
  • About author:
    Corresponding author: Wang Shuxiang, Email:
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引用本文：

王福安, 黄文诺, 吕朋华, 王书祥, 孙陵, 徐川, 葛俊. C臂锥体束CT成像技术在经皮椎体成形术中的临床应用[J]. 中华介入放射学电子杂志, 2017, 05(02): 98-101.

Fuan Wang, Wennuo Huang, Penghua Lyu, Shuxiang Wang, Ling Sun, Chuan Xu, Jun Ge. The clinical application of Cone Beam CT imaging technology in percutaneous vertebral plasty[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2017, 05(02): 98-101.

目的

探讨DSA的C臂锥体束CT（Cone Beam CT，CBCT）成像技术在经皮椎体成形术（PVP）中的应用价值。

方法

回顾性分析35例2013年1月—2016年7月在我中心行PVP治疗的椎体压缩性骨折和椎体肿瘤患者的临床资料，所有患者术中均采用CBCT技术。分析CBCT对术中穿刺情况及术后骨水泥填充情况的评价功能。

结果

所有患者均在局麻下成功完成PVP手术，均一次穿刺完成骨水泥充填。技术成功率100%。术后即刻DSA拍片，发现骨水泥渗漏9例（25.7%，9/35），其中Ⅰ型渗漏6例（17.1%，6/35），Ⅱ型渗漏3例（8.6%，3/35）。术后即刻CBCT检查发现骨水泥渗漏13例（37.1%，13/35），其中Ⅰ型渗漏6例（17.1%，6/35），Ⅱ型渗漏7例（20%，7/35）。PVP后即刻行CBCT检查较术后DSA即刻摄片对骨水泥分布情况了解更充分。

结论

CBCT在经皮椎体成形术中对及时发现骨水泥渗漏有重要的临床价值。

关键词: C臂锥体束计算机体层摄影术, 经皮椎体成形术, 椎体压缩性骨折, 椎体肿瘤
Objective:

To explore the application value of DSA C arm of the Cone Beam CT (CBCT) imaging in the percutaneous vertebral plasty (PVP) procedure.

Methods:

Relative clinical data of 35 patients with vertebral compression fractures and vertebral metastatic carcinoma who received percutaneous vertebral plasty under the guidance of CBCT in our center between January 2013 and July 2016 were retrospectively analyzed. The value and effect of CBCT in relation to postoperative bone cement filling were also evaluated.

Results:

All patients were treated by PVP with only one puncture under local anesthesia successfully. Immediate postoperative DSA X-ray showed that 9 cases had bone cement leakage (25.7%, 9/35), including type Ⅰ leakage(17.1%, 6/35) in 6 patients, and type Ⅱ leakage (8.6%, 3/35) in 3 patients. Immediate postoperative CBCT examination showed bone cement leakage in 13 patients (37.1%, 13/35), including 6 cases of type I leakage (17.1%, 6/35), and 7 cases of type Ⅱ leakage (20%, 7/35). The immediate CBCT after PVP demonstrated a better distribution of the bone cement than DSA X-ray image.

Conclusions:

CBCT in percutaneous vertebral plasty has important clinical value in detecting the leakage of bone cement immediately after PVP.

Key words: Cone Beam Computed tomography, Percutaneous Vertebral plasty, Vertebral compression fractures, Vertebral tumor
图1 65岁食管癌胸11椎体转移患者行DSA下经皮椎体成形术，术后即刻DSA摄片检查（1A、1B）和CBCT检查（1C、1D）
图2 75岁女性肺癌患者椎体内骨水泥充填前后
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