MRI post-vertebroplasty.
OBJECTIVE
Percutaneous vertebroplasty (PVP), first described by Hervè Deramond in 1984, is an interventional procedure for the treatment of aggressive vertebral angioma. The aim of this study was to evaluate magnetic resonance imaging (MRI) patterns in the affected vertebrae before and after vertebroplasty by determining changes in signal intensity and size and distribution of bone cement within the vertebra at follow-up carried out at 1 week, 6 months and 12 months.


METHODS
Fourteen patients were examined using MRI, for a total of 41 treated vertebrae; MRI was performed with a 0.5-Tesla (T) superconductive magnet (SIGNA GE).


RESULTS
MRI patterns following vertebroplasty are mainly characterised by the signal produced by the areas surrounding the cement and by the cement itself. There is little effect on the size of the treated vertebra. Acrylic cement appears as an intraspongy focal area of T1 and T2 hypointensity that is mostly oval (34%) or rounded (26.8%); this appearance tends to become stable 6 months after treatment. The area surrounding the cement appears hypointense on T1 and hyperintense on T2, a likely expression of bone marrow oedema; this signal alteration tends to disappear gradually.


CONCLUSIONS
In pre- and post-vertebroplasty imaging, MRI is regarded as the reference standard for correct evaluation of both container and content. Awareness of cement changes over time and of the reaction of the surrounding bone tissue is crucial for correct assessment of post-vertebroplasty images.
Fossaceca
R
R
Department of Diagnostic and Interventional Radiology, Maggiore della Carità University Hospital, Corso Mazzini 18, I-28100, Novara, Italy.
Di Terlizzi
M
M
Stecco
A
A
Canalis
L
L
Travaglini
F
F
Ambrosini
R
R
Carriero
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications; D010024:Osteoporosis / Q000150:complications; D019904:Polymethyl Methacrylate; D013122:Spinal Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016103:Spinal Fractures / Q000601:surgery; D013131:Spine / Q000473:pathology*
D001843:Bone Cements; D019904:Polymethyl Methacrylate