开放式MR导引下经皮椎体成形术在椎体转移瘤治疗中的应用研究  

Full-open MR-navigated percutaneous vertebroplasty in the treatment of vertebral metastases

作　　者：金光鑫[1] 代孟君 仇晓霞[2] 丁敏[1] 潘磊 张学彬[1] JIN Guangxin;DAI Mengjun;QIU Xiaoxia;DING Min;PAN Lei;ZHANG Xuebin(Department of Interventional Oncology,Affiliated Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院肿瘤介入科,200127 [2]上海交通大学医学院附属仁济医院肿瘤科,200127

出　　处：《介入放射学杂志》2019年第11期1071-1075,共5页Journal of Interventional Radiology

基　　金：上海市科委科技支撑项目（19441907000）;上海交通大学医学院附属仁济医院创新培育基金（PYXJS16010）

摘　　要：目的初步评价开放式磁共振(MR)引导下经皮椎体成形术(PVP)的可行性、安全性和有效性。方法回顾性分析2014年1月至2018年6月收治的溶骨性椎体转移瘤17例(29节椎体)。采用0.4 T开放式MR成像系统结合光学导航仪系统行PVP,观察术前、术后视觉模拟评分(VAS)、美国东部肿瘤协作组(ECOG)评分、椎体前缘高度及术后相关并发症。结果 17例患者(29节椎体)均准确穿刺至拟定靶点,顺利完成PVP。术后VAS、ECOG评分均低于术前(P<0.05),椎体前缘高度与术前相比差异无统计学意义(P>0.05)。术后5节段椎体发生骨水泥外渗,2例出现穿刺点皮下血肿,无严重并发症发生。结论 MR导航引导下PVP成像清晰、导引准确,是一种安全有效的椎体转移瘤治疗方法。Objective To evaluate the feasibility, safety and effectiveness of performing percutaneous vertebroplasty(PVP) for vertebral metastases under open magnetic resonance(MR) guidance. Methods The clinical data of 17 patients with osteolytic vertebral metastases(29 diseased vertebrae in total), who were admitted to authors’ hospital during the period from January 2014 to June 2018, were retrospectively analyzed. By using a 0.4 T MR system combined with optical navigation system, PVP was performed in all patients. The preoperative and postoperative visual analogue scale(VAS) scores, the eastern United States cooperative oncology group(ECOG) scores, the anterior height of the vertebra, and complications were recorded. Results Accurate puncturing to the target point was achieved in treating all 29 diseased vertebrae of the 17 patients, and PVP procedure was successfully accomplished. Both postoperative VAS and ECOG scores were remarkably lower than preoperative ones(P<0.05). The postoperative mean anterior height of the vertebrae showed no statistically significant changes when compared with preoperative value(P>0.05). After PVP, bone cement leakage occurred in 5 vertebrae and subcutaneous hematoma at puncture point occurred in2 patients. Conclusion In performing PVP, MR navigation can obtain clear imaging, which is very helpful for precise guidance and perform of PVP. This technique is a safe and effective treatment for metastatic vertebral metastases.

关 键 词：开放式磁共振成像 光学导航 经皮椎体成形术 椎体转移瘤 

分 类 号：R738.1[医药卫生—肿瘤]