Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.
Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
Skeletal Radiol. 2021 Jul;50(7):1461-1464. doi: 10.1007/s00256-020-03671-x. Epub 2020 Nov 13.
Pulsatile intra-osseous pressures result in bone remodeling, and therefore may affect lesion growth and response to treatment. However, there is no known method used to measure intra-osseous pressures. The purpose of this study is to describe a novel image-guided technique for measuring intra-osseous pressures.
This study was IRB-approved and HIPAA compliant. Written informed consent was obtained. Intra-osseous pressure measurements were performed during a CT-guided bone marrow biopsy in eight patients (6 male, 2 female) with mean age 66 ± 13 years (median 72, range 45-87) and suspected or known bone marrow disease. Bone marrow pressure measurements were obtained connecting the biopsy needle to a dedicated monitor using a standard arterial line setup. Monitor data was collected at 5-s intervals in order to record continuous pressure measurements for 2 min.
Pressure measurements were successfully performed in all 8 patients. The mean bone marrow pressures were 36.8 ± 7.2 mmHg (median 37.7, range 24.7-47.4). The peak and trough pressures varied by 11%, and the standard deviation of mean pressure measurement varied by 18%. Our findings for marrow pressure measures most closely approximate the pressure profile of the venous system.
We describe a novel and minimally invasive technique able to provide functional data of bone marrow. This technique has the potential to provide insights into normal and diseased bone marrow and may be helpful to evaluate features of cystic and vascular tumors that may be amenable to percutaneous treatments.
脉动性骨内压会导致骨重塑，因此可能会影响病变的生长和对治疗的反应。然而，目前还没有已知的方法用于测量骨内压。本研究旨在描述一种新的用于测量骨内压的图像引导技术。
本研究经机构审查委员会批准并符合 HIPAA 规定。患者签署了书面知情同意书。在 8 例（6 例男性，2 例女性）疑似或已知骨髓疾病的患者中，在 CT 引导下进行骨髓活检时进行了骨内压测量。通过将活检针连接到专用监视器，使用标准动脉置管装置来进行骨髓压测量。以 5 秒的间隔收集监视器数据，以记录连续压力测量 2 分钟。
所有 8 例患者均成功进行了压力测量。平均骨髓压力为 36.8±7.2mmHg（中位数 37.7，范围 24.7-47.4）。峰压和谷压相差 11%，平均压力测量的标准差相差 18%。我们的骨髓压力测量结果最接近静脉系统的压力曲线。
我们描述了一种新的微创技术，能够提供骨髓的功能数据。该技术有可能深入了解正常和患病骨髓，并可能有助于评估囊性和血管性肿瘤的特征，这些特征可能适合经皮治疗。
