3D-CT在经皮穿刺椎体成形术治疗椎体转移瘤中的应用

目的 观察3D-CT扫描成像应用于经皮穿刺椎体成形术（pVP）治疗椎体骨转移瘤的临床效果.方法 根据46例脊柱转移瘤患者共62个椎体的术前影像资料,经患侧（或双侧）椎弓根入路穿刺并注入骨水泥.配合数字减影血管造影（DSA） 3D-CT扫描成像观察穿刺针在椎体和椎弓根内的位置、骨水泥在椎体内的分布和椎体外泄漏情况等,观察术后1周的止痛效果及并发症.结果 椎体内骨水泥注射量为2.0～5.0 mL.术后1周患者治疗后疼痛症状均有不同程度缓解,止痛总有效率为91.3％（42/46）,并发症发生率为17.4％（8/46）.结论 DSA 3D-CT可以更直观地监测PVP穿刺过程,更快速有效地了解骨水泥的分布、使用剂量及骨水泥渗漏情况,在缓解脊柱转移瘤疼痛方面效果更加显著,增加手术有效性和安全性.

Application of 3D-CT in treatment of vertebral metastases by percutaneous vertebroplasty

Objective To observe the clinical effect of 3D-CT scanning technique on treat- ment of vertebral metastases by percutaneous vertebroplasty （PVP）. Methods 46 patients （62 vertebrals） with vertebral metastasis were treated with percutaneous vertebroplasty according to CT or MRI images before surgery. Bone cements were injected into vertebral through pedicle of vertebral arch from affected side （or both sides）. The position of puncture needle in vertebral body and pedi- cle of vertebral arch, the distribution and the leakage of the bone cement in and out of vertebral were observed by 3D-CT scanning technique during operation. Results Bone cement volume was 2.0 5.0 mL. The total analgesic effective rate was 91.3% （42/46）. The complication rate was 17.4% （8/46）. Conclusion 3D-CT scanning technique can offer a direct observation on PVP. It is easy to observe the distribution, the volume and the leakage of the bone cement during surgery and improve the safety and efficacy of PVP.