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| Strategies for imaging evaluation of cement leakages after percutaneous vertebroplasty |
| ZHANG Jing, ZHANG Nan, GUO Yong, WANG Qingjun, SHI Lijing |
| Department of Radiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China |
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Abstract Objective To assess retrospectively the images of cement leakages and to evaluate X-ray and CT for the complications of percutaneous vertebroplasty (PVP). Methods Eighty patients underwent PVP and a total of 102 vertebrae were treated between January 2016 and December 2019. X-ray examinations were performed in all the patients after PVP while CT examinations were performed in 36 patients.The locations and features of cement leakages of each vertebra were recorded and analyzed. Results Seventy-seven locations of cement leakages were detected in a total of 47 vertebrae in 36 patients by CT, including 30 paravertebral venous leakages, 9 spinal canal leakages,15 paravertebral soft tissue leakages, 17 intrevertebral discs leakages,and 6 needle tract leakages.The leakage rate was 46.1%.Sixty locations of cement leakages were detected by X-ray (78.0%).The dominating cement leakage was venous leakages(39.0%), as inferior vena cava emblism was detected in 3 patients(3.9%), azygos embolism in 2 patients(2.6%), and pulmonary embolism in 4 patiends(5.1%). Conclusions CT three-dimensional reconstruction combined with X-ray is an effective approach to the evaluation of cement leakages of PVP. Vertebral CT and thoracic CT can facilitate early detection of such venous leakages as inferior vena cava embolism, azygos embolism and pulmonary embolism. Moreover, vertebral CT can be conducive to early detection of spinal damages in case of spinal canal leakage.
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Received: 30 December 2019
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2020, Vol. 31 
