赚钱行业排行榜

志行学院

NUDGING ACADEMY

椎体成形术后肺栓塞的影像学解析

ZHUITICHENGXING



骨折或病变的椎体最常见的治疗方法是向椎体内注入骨水泥,以恢复椎体形态。但注入椎体内的骨水泥在一些情况下可以进入到静脉系统内,导致肺栓塞。现结合宾夕法尼亚大学影像科的 Duke Duncan 医生在 auntminnie 上发布的病例来对该病进行介绍。



骨水泥渗漏后,可因注入时的压力进入椎体中央静脉,然后弥散进入邻近血管,常常是栓塞椎旁静脉丛,一般大多数椎旁静脉丛的栓塞不会给患者带来不适,然而当栓子足够大时可能导致压迫、灼伤脊髓和(或)神经根,栓塞血管,导致椎体的缺血坏死。椎体后壁基底静脉孔是骨水泥渗漏的常见通道之一,并由此可能渗漏的骨水泥进入周围静脉,以引起肺栓塞最为严重。实例如下:


病史:


71 SUINVXING,JINQIXINZANGSHUHOUKESOU。


影像学检查及发现


丨图1


图 1 为胸部正位片,可见右肺上叶纤维灶(红色箭头),左膈面抬高(黄色箭头)和胸骨金属缝线影(绿色箭头)


丨图2


赚钱行业排行榜 TU 2 WEIXIONGPIANCEWEI,KEJIANDUOGEXIONGZHUIZHUITINEIJIANGUSHUINIYING(HONGSEJIANTOU),GUSHUINIJINRUDAOZHUIPANGJINGMAINEI(HUANGSEJIANTOU)


丨图3


赚钱行业排行榜 TU 3 WEI CT GUCHUANG,XIONGZHUIZHUITINEIJIANGUSHUINIYING(HONGSEJIANTOU),ZHUIPANGJINGMAIJIFEIDONGMAIFENZHINEIJIANGAOMIDUYING,JIGUSHUINI(HUANGSEJIANTOU)


丨图4


赚钱行业排行榜 TU 4 WEI CT GUCHUANG,FEIDONGMAIFENZHINEIJIANGAOMIDUYING,JIGUSHUINI(HONGSEJIANTOU)


影像学发现平片:右肺上叶条索影,左膈面抬高。侧位片见部分胸椎内骨水泥影。胸骨见金属缝线影。 CT:示肺动脉分支内见高密度影。重塑胸椎水平骨窗示骨水泥溢出并进入邻近的椎旁静脉。


诊断骨水泥肺动脉栓塞


鉴别诊断赚钱行业排行榜慢性肺动脉栓子钙化、动脉内置物破裂致肺动脉栓塞、骨水泥栓塞肺动脉、骨肉瘤栓。



影像学表现

赚钱行业排行榜 PINGPIAN:PINGPIANSHIFEIDONGMAIFENZHINEIGAOMIDUFENZHIJIEGOUYING。 CT:FEIDONGMAIFENZHINEIGAOMIDUYING,CT ZHIGAOYU 100 Hu。 CHANGGUIXUEGUANZAOYING:KEBIAOXIANWEIFEIDONGMAIFENZHITURANJIEDUAN。


讨论

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赚钱行业排行榜 JINGUANCUNZAIGUSHUINIXIANGZHUIGUANNEISHENLOUDEKENENG,DANYEYOUXIANGGUANBAODAOZHUIGUANNEISHENLOUDEFASHENGLVJIDI,ZHEIKENENGYUCAOZUOZHEDESHOUSHUJIQIAOYOUGUAN,DANBUNENGZUOWEISHOUSHUCHENGGONGDEBIAOZHI。JINGUANGUSHUINIZHIFEISHUANSAIDEKENENGXINGXIAO,DANLINCHUANGZHONGQUEYOUBUSHAOBAODAO,RURENZHENYIDENGFAXIAN1LIJINGPIYAOZHUICHENGXINGSHUHOUGUSHUINIFEISHUANSAI,YINCIZHIDELINCHUANGYISHIDEJINGTI。

 

丨欧固™Eurofix vtp脊柱骨水泥