多种影像技术在经皮椎体成形术中的应用

Application of multiple image technologies in percutaneous vertebroplasty

目的探讨CT、MRI和数字减影血管造影(DSA)影像技术在经皮椎体成形术(PVP)中的应用效果。方法 MRI及CT检查确认36例患者的病变椎体,术前在CT图像上模拟穿刺路径及选择PVP穿刺方式,在DSA引导下行PVP、MRI及CT评价PVP前后椎体高度及形态学变化,术前与术后1周视觉模拟评分法(VAS)评价PVP的临床疗效。结果共确认41节责任椎体。其中,14节单侧入路,27节双侧入路;36例患者均在DSA引导下顺利完成PVP。前缘和中央椎体高度均高于治疗前[(19.79±3.18)mm vs.(17.66±2.15)mm和(14.58±2.52)mm vs.(12.68±1.52)mm](P<0.01)。术后1周VAS评分较术前明显改善[(0.8±0.8)分vs.(7.8±1.5)分](P<0.01),术后1周疼痛缓解率为97.2%(35/36)。结论多种影像技术复合应用有利于改善PVP效果。

Objective To explore the application efficiency of multiple image technologies in percutaneous vertebroplasty（PVP）. Methods Targeted centrums were determined by MRI and CT scanning in 36 patients. Puncture approachs were simulated and selected on CT images before operation. PVP was condlacted under the guidance of digital subtraction angiography（DSA）. Vertebral height and morphological change were evaluated by MRI and CT before and after treatment. Clinical effects were evaluated by visual analogue score（VAS） before and on the first week after treatment. Results Forty-one targeted centrums were determined. PVP was successfully conducted in 36 patients under the guidance of DSA, of whom unilateral approach was used in 14 centrums and bilateral approach was used in 27 centrums. Frontal and central vertebral heights were higher after treatment than those before[（19.79±3. 18） mm vs. （17.66±2.15） mm and （14.58±2. 52） mm vs. （12.68± 1.52） mm]（P〈0. 01）. Sore of VAS was lower after treatment than that before [（0.8±0.8） points vs. （7.8±1.5） points]（P〈0. 01）with a pain relief rate of 97.2%. Conclusion The better outcomes can be reached by combined use of multiple image technologies for PVP.