C臂CT引导穿刺灌注骨水泥治疗扁骨转移的临床研究  

Clinical study on C-arm CT-guided puncture perfusion bone cement for the treatment of flat bone metastasis

作　　者：谢志勇[1] 崔锡范 刘长瑞[1] 刘训伟[1] 王志国[1] 杜艳霞[1] 孙钢[1] 

机构地区：[1]济南军区总医院医学影像科,山东济南250031 [2]山东省沂源县中医医院骨科,山东沂源256100

出　　处：《医学影像学杂志》2017年第4期732-735,共4页Journal of Medical Imaging

基　　金：国家高技术研究发展计划(863计划)资助(编号:2013AA032203);国家自然科学基金资助(编号:81671799)

摘　　要：目的探讨DSA引导下穿刺及骨水泥灌注治疗扁骨转移瘤的安全性和有效性。方法 21例患者均在INNOVA 4100引导下完成,在透视监视下行穿刺和骨水泥灌注,应用C臂CT确定穿刺位置、针尖位置及骨水泥弥散情况,并与透视采集图像比较,评价准确性。结果 21例患者均顺利完成手术。透视在扁骨穿刺时对针尖位置、骨水泥渗漏的准确性分别是71.4%和85.7%,低于C臂CT重建图像的100%。手术能较好改善患者的临床症状,治疗前后VAS及ODI评分比较差异有显著意义(P<0.05)。结论 DSA的C臂CT功能在扁骨行POP时,可避免穿刺及骨水泥灌注观察不到位的情况发生,提高了手术安全性。Objective To evaluate the safety and efficacy of INNOVA4100 guided percutaneous puncture and bone cement perfusion in the treatment of flat bone metastases. Methods All of the 21 patients were guided by INNOVA4100, and the puncture and bone cement perfusion were performed under the perspective of the X-ray monitoring. Using C-arm, CT, we determined the puncture, the needle tip position and bone cement dispersion situation, compared with the X-ray of the collection image and evaluated the accuracy of the result. Results 21 patients were successfully completed surgery. In the radioscopy-guided flat bone, the puncture needle position and bone cement accuracy were 71.4% and 85.7% and less than 100% of the reconstructed image of 3D. Surgery can improve the clinical symptoms of patients, VAS and ODI score before and after surgery, which was significant （ P 〈 0.05）. Conclusion The C-arm, CT function of INNOVA4100 in percutaneous osteopasty of flat bone, which could prevent the occurrence of puncture and bone cement perfusion is not in place, improves the safety of the operation.

关 键 词：扁骨 骨转移 溶骨性 经皮骨成形术 

分 类 号：R738.1[医药卫生—肿瘤] R815[医药卫生—临床医学]