Intravertebral cleft sign on fat-suppressed contrast-enhanced MR: Correlation with cement distribution pattern on percutaneous vertebroplasty
Intravertebral cleft sign on fat-suppressed contrast-enhanced MR: Correlation with cement distribution pattern on percutaneous vertebroplasty
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DOI：
10.1016/j.acra.2005.05.003
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发表时间：
2005-08-01
影响因子：
4.8
通讯作者：
Numaguchi, Y
中科院分区：
文献类型：
--
作者：
Oka, M;Matsusako, M;Numaguchi, Y
Rationale and Objectives. Filling intravertebral clefts during percutaneous vertebroplasty (PVP) is considered to be important for optimal pain control. It is often difficult to detect clefts on non-contrast MR and some fractures show a solid pattern distribution of injected cement without a cleft sign on non-contrast MR. In this study, we evaluated usefulness of fat-suppressed contrast-enhanced MR to predict a solid pattern distribution of injected cement on PVP.Materials and Methods. Twenty-six patients with 35 vertebral compression fractures due to osteoporosis were studied. We performed sagittal T1-weighted, T2-weighted and fat-suppressed contrast-enhanced T1-weighted images prior to PVP. First we evaluated the presence of fluid-filled or gas-containing clefts on non-contrast MR. Next we evaluated contrast-enhanced MR of the same vertebrae for the presence of cleft-shaped unenhanced areas within the diffuse enhancement area. We correlated MR findings with cement distribution patterns of injected cement.Results. Based on MR findings, 35 osteoporotic fractures were divided into 3 types. Type 1 (11 fractures, 31%): There were no clefts on non-contrast MR and no unenhanced areas on contrast-enhanced MR; Type 2 (13, 37%): There were no clefts on non-contrast MR but there were unenhanced areas on contrast-enhanced MR; Type 3 (13, 37%): There were clefts on non-contrast MR and unenhanced areas on contrast-enhanced MR. Of 35 osteoporotic fractures, thirteen vertebral fractures (37%) were noted to contain clefts on non-contrast MR, while 24 vertebral fractures (69%) contained unenhanced areas on contrast-enhanced MR. Cement distributed as a solid pattern within clefts or unenhanced areas in all fractures with them.Conclusion. Fat-suppressed contrast-enhanced MR is useful to predict a solid pattern distribution of injected cement prior to PVP.
