Magnetic Resonance Enhancement Pattern as a Predictor of Cement Volume in Vertebroplasty Procedures for Osteoporotic Fractures

ABSTRACT

PURPOSE: To identify the differences between injected cement volumes during vertebroplasty procedures according to the enhancement pattern of pre-procedure magnetic resonance imaging (MRI) findings. MATERIALS AND METHODS: Thirty-two patients who underwent 52 vertebroplasty procedures as well as pre-procedure contrast-enhanced spine MRI in the authors' institution were reviewed retrospectively. The 52 procedures were divided into two groups according to different enhancement patterns shown by pre-procedure MR imaging [E(+) and E(−)]. The volumes of the enhancing/non-enhancing portions of the fractured vertebral body shown by pre-procedural MR imaging were calculated and compared to the volumes of the injected cement during the vertebroplasty procedures. RESULTS: The 52 injections included 28 (56%) in Group E(+) and 24 (44%) in Group E(−). The actual volume ratio of the injected cement to the volume of the non-enhanced or enhanced region calculated based on the contrast-enhanced MRI was 0.22 ± 0.11 (cc/cm³) in the E(+) group and 0.93 ± 0.62 (cc/cm³) in the E(−) group. The average amount of injected cement was significantly different between Group E(+) and Group E(−) (P < 0.001). In addition, the ratio of the injected cement amount to the volume of the enhanced or non-enhanced portion based on the contrast-enhanced MRI in Group E(−) was significantly higher than that of Group E(+) (P < 0.001). CONCLUSION: Different enhancement patterns shown by pre-procedure MRI can predictors of the injected cement volume during vertebroplasty procedures for osteoporotic fractures.