经皮椎体成形术后MRI影像与临床转归关系的研究

发布时间：2018-10-29 20:24

【摘要】：目的:观察经皮椎体成形术(PVP)后手术椎体随访的核磁共振影像(MRI)特点,分析其与临床疗效的相关性。方法:回顾性分析2015.1-2016.1在我院行椎体成形术的198例患者的临床资料,其中资料完整且符合纳入标准的患者为108例(152治疗椎体),分析年龄,性别,椎体骨水泥的注入量,术前、术后1天X线影像(椎体高度),术前、术后3月、6月随访MRI影像结果(椎体高度、骨髓水肿)及术前、术后1天、术后3月、术后6月疼痛视觉模拟评分(VAS),并且着重收录、分析、观察患者术后的临床表现。结果:术前和术后1天VAS分别为6.7±1.4分和2.1±0.7,差异有统计学意义(P0.05),术后3月和术后6月VAS分别为1.7±0.8和1.2±0.6分。术后手术椎体高度较术前增加了2.4±1.8mm,术后六月随访中手术椎体高度丢失0.8±0.5mm,病人统计资料和椎体骨水泥注入量与PVP术后椎体高度丢失无关。其中28个(18%)椎体术后存在椎体高度丢失。62%的椎体术前MRI影像和33%椎体的随访MRI影像表现为椎体的中度或严重骨髓水肿。21%的椎体在随访时出现了新的骨髓水肿区域。22%的椎体在术后6个月的MRI影像中出现中度或重度的骨髓水肿。结论:PVP治疗椎体骨质疏松性压缩骨折(OVCF)疗效明显,进展性和持续性的骨髓水肿和椎体高度丢失是PVP术后常见的,不应被视为手术椎体术后异常的足够证据。
[Abstract]:Objective: to observe the magnetic resonance imaging (MRI) features of vertebra follow-up after percutaneous vertebroplasty (PVP) and to analyze its correlation with clinical efficacy. Methods: the clinical data of 198 patients underwent vertebroplasty in our hospital from January to June 2015.108 patients (152 treated vertebrae) with complete data were analyzed. The amount of bone cement injected into the vertebral body, X-ray imaging (vertebral height) before and 1 day after operation, MRI imaging results (vertebral height, bone marrow edema) before operation, 3 months after operation, and before operation, 1 day after operation, 3 months after operation. Visual analogue score (VAS),) of postoperative pain was collected and analyzed to observe the clinical manifestations of the patients. Results: VAS was 6.7 卤1.4 and 2.1 卤0.7 before operation and 1 day after operation, respectively (P0.05). VAS was 1.7 卤0.8 and 1.2 卤0.6 in 3 months and 6 months after operation, respectively. The postoperative vertebral body height increased by 2.4 卤1.8 mm compared with that before operation, and the loss of postoperative vertebral body height was 0.8 卤0.5 mm during 6 months follow-up. There was no correlation between the patient's statistical data and the amount of cement injected into the vertebral body after PVP. Among them, 28 (18%) had high loss of vertebral body after operation. 62% of the patients had preoperative MRI imaging and 33% of the follow-up MRI images showed moderate or severe bone marrow edema. 21% of the vertebrae showed moderate or severe bone marrow edema. New areas of bone marrow edema. 22% of vertebrae showed moderate or severe bone marrow edema on MRI imaging 6 months after operation. Conclusion: PVP is effective in the treatment of osteoporotic compression fracture of vertebral body (OVCF). Progressive and persistent bone marrow edema and loss of vertebral body height are common after PVP and should not be regarded as sufficient evidence of postoperative abnormality of vertebral body.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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