Yevich Steven, Tselikas Lambros, Gravel Guillaume, de Baère Thierry, Deschamps Frederic
Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Interventional Radiology, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.
Semin Intervent Radiol. 2018 Oct;35(4):268-280. doi: 10.1055/s-0038-1673418. Epub 2018 Nov 5.
The technical art to percutaneous injection of polymethyl methacrylate (PMMA) cement for the palliative treatment of osseous metastases is not without pitfalls. Pathologic fracture, cortical bone erosion, large lytic tumor, aggressive tumor biology, and tumor vascularity may increase the risk of cement leakage or limit complete consolidation. A calculated and determined approach is often necessary to achieve satisfactory patient-tailored results. This article reviews the challenges and potential complications during the consolidation of osseous metastases. Case examples are presented to facilitate early detection of impending cement leakage, minimize procedural risks, and provide management suggestions for complications. Technical pearls are provided to refine consolidative techniques and improve the comprehensive treatment of painful osseous metastases.
经皮注射聚甲基丙烯酸甲酯（PMMA）骨水泥用于骨转移瘤姑息治疗的技术并非毫无风险。病理性骨折、皮质骨侵蚀、大的溶骨性肿瘤、侵袭性肿瘤生物学行为以及肿瘤血管情况可能会增加骨水泥渗漏的风险或限制完全固化。通常需要一种经过深思熟虑且果断的方法来取得令患者满意的个性化治疗效果。本文回顾了骨转移瘤固化过程中的挑战和潜在并发症。文中列举了病例以促进对即将发生的骨水泥渗漏的早期检测、将操作风险降至最低，并为并发症提供处理建议。还提供了技术要点以完善固化技术并改善对疼痛性骨转移瘤的综合治疗。
