Abstract

Objective

The purpose of this study is first to determine the clinical utility of the postprocedure scan in detecting postinterventional complications after CT-guided musculoskeletal biopsies, and second to evaluate the contribution to the radiation dose of the postprocedural CT scan.

Materials and methods

Retrospective analysis of 500 consecutive CT-guided musculoskeletal biopsies over an 18-month period from 29 March 2017 to 28 September 2018, where spiral postprocedure scans were obtained in every case. To assess the clinical utility of postinterventional CT scans, it was determined whether immediate post-procedural complications were detected on the postprocedural scans only or were also seen on the procedural images. To evaluate the relative radiation exposure of postprocedural scans, a ratio was obtained of the dose–length product (DLP) of the postprocedural scan compared with the total DLP of each case.

Results

A total of 397 bone biopsies and 103 soft-tissue biopsies were performed in 471 patients. The immediate postprocedural complication rate was 0.4% (2 out of 500) in all procedures. Both complications were minor (small hematomas) and detected only on postinterventional CT scans. The average total DLP for the procedures was 383.5 mGy*cm. The average DLP of the postprocedural scan was 64.0 mGy*cm. The average radiation dose contribution of the postprocedural CT scans toward the total DLP was 17.4%.

Conclusion

Immediate postprocedural complications in CT-guided musculoskeletal interventions are rare. When complications do occur, they are usually minor. To substantially reduce radiation dose, postinterventional CT scans should not be performed routinely.

中文翻译：

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术后CT扫描在CT引导的肌肉骨骼活检中的临床应用

摘要

目的

这项研究的目的是首先确定过程后扫描在检测CT引导的肌肉骨骼活检后的介入后并发症中的临床效用，其次是评估过程后CT扫描对放射剂量的贡献。

材料和方法

自2017年3月29日至2018年9月28日的18个月期间，对500例连续的CT引导的肌肉骨骼活检进行了回顾性分析，在每种情况下均获得了螺旋式术后扫描。为了评估介入后CT扫描的临床效用，确定是仅在手术后扫描中检测到了手术后即刻并发症还是在手术图像上也看到了手术后并发症。为了评估手术后扫描的相对辐射暴露，获得了手术后扫描的剂量长度乘积（DLP）与每种情况下的总DLP之比。

结果

471例患者共进行了397例骨活检和103例软组织活检。在所有程序中，术后立即并发症发生率为0.4％（500分之二）。两种并发症均为轻度（小血肿），仅在介入后CT扫描中发现。该过程的平均总DLP为383.5 mG​​y * cm。术后扫描的平均DLP为64.0 mGy * cm。术后CT扫描对总DLP的平均辐射剂量贡献为17.4％。

结论

在CT引导的肌肉骨骼干预中立即发生的术后并发症很少。当确实发生并发症时，它们通常很小。为了大幅度降低放射剂量，介入治疗后不应常规进行CT扫描。