Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street - YAW 6, Boston, MA, 02114, USA.
Skeletal Radiol. 2024 Mar;53(3):481-487. doi: 10.1007/s00256-023-04431-3. Epub 2023 Aug 28.
The purposes of this study were (1) to establish the feasibility and safety of an imaging-guided technique for intraosseous pressure (IOP) measurement in a large cohort of patients, and (2) to compare IOP values between normal and diseased bone marrow.
Adult patients undergoing CT-guided marrow biopsy were prospectively and consecutively enrolled from November 2020 to February 2022. IOP measurements were obtained connecting the biopsy needle to a monitoring device using a standard arterial line setup. Clinical data including sex, age and pathology results were obtained. Student t test and Pearson correlation were used for continuous variables comparisons. Univariable analyses were performed using Fisher's exact test. A P value of .05 was considered statistically significant.
A total of 139 participants were initially enrolled, and four were excluded during technique optimization. There were no complications related to the measurement technique. Ninety participants (90/135, 67%) had histology confirming marrow pathology. The participants in the diseased marrow group were older than those in the normal marrow group (63 ± 14 vs. 55 ± 14 years; P < .01). There was no difference in mean IOP between both groups (66 ± 23 vs. 64 ± 28 mmHg; P = .69). There was no correlation between mean arterial blood pressure and mean IOP (P = .08).
There was no difference in IOP measurements between patients with normal and diseased marrow undergoing CT-guided biopsy. IOP does not appear to be influenced by systemic blood pressure. No complication occurred during the procedures.
本研究旨在（1）确立一种影像学引导下的骨内压（IOP）测量技术在大量患者中的可行性和安全性；（2）比较正常和病变骨髓的 IOP 值。
2020 年 11 月至 2022 年 2 月，前瞻性连续纳入接受 CT 引导下骨髓活检的成年患者。通过标准动脉线路设置将活检针与监测设备连接以获得 IOP 测量值。获得包括性别、年龄和病理结果在内的临床数据。采用 Student t 检验和 Pearson 相关分析进行连续变量比较。采用 Fisher 确切检验进行单变量分析。P 值<.05 被认为具有统计学意义。
共纳入 135 名患者，在技术优化过程中有 4 名患者被排除。测量技术无相关并发症。90 名（90/135，67%）患者的组织学证实有骨髓病理学改变。病变骨髓组患者的年龄大于正常骨髓组（63±14 岁 vs. 55±14 岁；P<.01）。两组的平均 IOP 无差异（66±23 毫米汞柱 vs. 64±28 毫米汞柱；P=.69）。平均动脉血压与平均 IOP 之间无相关性（P=.08）。
在接受 CT 引导活检的正常和病变骨髓患者中，IOP 测量值无差异。IOP 似乎不受全身血压的影响。在操作过程中未发生并发症。
