Interventional diagnostic and therapeutic techniques have developed rapidly in recent years with more and more practically and widely utilization as time goes by. The diagnostic procedures consist of percutaneous biopsy, CT discography, pressure measurement of intervertebral disc; and the therapeutic measures include percutaneous periradicular and joint therapy, decompression of sacral cyst, vertebroplasty, kyphoplasty, decompression of intervertebral disc, transarterial chemotherapy and embolization in spinal tumor, and newly developed percutaneous posterior lumbar intervertebral fusion. All above mentioned interventional techniques for spinal column diseases are developing day by day with a promising future and will play an important role in the field of interventional radiologist research.

Many interventional procedures have been practiced in the treatment of cervical spine diseases for recent years. There are percutaneous biopsy, periradicular therapy for cervical never pain, percutaneous vertebroplasty and many kinds of intervertebral disc decompression. However, because of the manipulation difficulties and high risks of these procedures the popularization of interventional techniques in treating cervical spine disorders has actually been beset with difficulties. The main risks caused by interventional operation are puncture injuries and side-effect of therapeutic design. Therefore, how to reduce the procedure’s risk is a great challenge to interventional radiologists as well as an urgent research task.

Percutaneous sacroplasty is a technique, derived from percutaneous vertebroplasty, with minimal invasion and better safety for refractory sacroiliac pain. The procedure is involved with bone cement injected into the diseased sacral body under fluoroscopic or computed tomography guidance and in turn for stabilizing and strengthening the vertebral body with outcome of decrease or even complete relief of pain. The author introduces and comprehends the definition, preoperative imaging examinations, indications, contraindications, techniques and complications of the procedure.

Objective To discuss different performance of DR and CT examination on secondary pulmonary tuberculosis,to improve the clinical guidance value of CT in the diagnosis of secondary pulmonary tuberculosis. Methods The image data of 52 cases with secondary pulmonary tuberculosis confirmed by pathology were collected, including chest DR radiography and CT scans.The different image characteristics of two kinds of imaging examination were analyzed and compared.Results In 52 cases of secondary pulmonary tuberculosis,chest X -ray plain film found lesions calcification in 3 cases,2 cases of bronchiectasis,pleural thickening and adhesion in 12 cases,pleural effusion in 1 case,empty cavity in 4 cases,emphysema in 1 case,the lung nodules in 5 cases.Chest CT revealed lesions calcification in 9 cases,16 cases of bronchiectasis,pleural thickening and adhesion in 40 cases,pleural effu-sion in 4 cases,empty cavity in 10 cases,emphysema in 8 cases,the lung nodules in 10 cases,6 cases of pulmonary bullae,pulmonary interstitial change:4 cases of lung reticulocyte shadows,interlobular septal thickening in 4 cases, ground glass sample density in 4 cases.Conclusion DR and CT can be used for inspection of secondary pulmonary tuberculosis,but CT is a better tool,it has important guiding role for clinical diagnosis and treatment.

BACKGROUND: Bone cementoplasty can elevate the life quality of patients by instant alleviating pain and stable fracture. However, the effects of bone cementoplasty should be further analyzed due to it is lack of long-term follow-up and clinical practices.OBJECTIVE: To retrospectively analyze the therapeutic effect of bone cementoplasty accompanied by radiotherapy for malignant tumor patients with bone metastaese.METHODS: Totally 60 malignant tumor patients with bone metastaese treated in Shanghai Sixth Peoples' Hospital from September 2006 to February 2009 were randomly divided into 2 group, with 30 cases in each group. In the radiotherapy group, patients were exposed to 6 MV X-ray, 2 Gy once, 5 times per week, for 4 successive weeks. In the combination group, patients were underwent bone cementoplasty accompanied by radiotherapy. The combination of verbal rating scale (VRS) and visual analogue scale (VAS) were used to assess bone pain. The onset times of two groups were compared. RESULTS AND CONCLUSION: The scores of bone pain were similar between before and after treatment (P > 0.05). Compared with the radiotherapy group, the bone pain of combination group was significantly relieved after treatment (P<0.05). There were 13 patients were ineffective to treatment in the radiotherapy group, which was 8 patients in the combination group. In addition, the onset time of radiotherapy group was later than that of the combination group. In the 10-month follow-up, 25 patients in the radiotherapy group and 21 patients in the combination group were dead. The survival patients of combination group were greater that those of radiotherapy group. No evidence showed that the death was correlated to bone cement, namely, bone cementoplasty accompanied by radiotherapy can be more effective in the treatment of bone metastases than simple radiotherapy,and it might be the first choice in clinical practice.Huang YF, Fu S, Wu CG.Bone cementoplasty accompanied by radiotherapy for malignant tumor patients with bone metastaese:

Objective To discuss the clinical value of percutaneous vertebroplasty (PVP) in treating severe vertebral compression fracture. Methods During the period from June 2012 to March 2013, PVP was carried out in 30 patients with severe vertebral compression fracture (30 diseased vertebrae in total). The clinical data were respectively analyzed. According to the shape of compressed vertebra , the fractures were divided into three types: wedge-shaped, double concave and oblong-shaped. For wedge-shaped fracture, PVP was performed via the pedicle access of the healthy side. For double concave type , unilateral pedicle access was used, while for oblong-shaped type unilateral or bilateral access was adopted to conduct PVP according to the distribution of the injected PMMA. The therapeutic results were evaluated by using VAS and pain degree classification standard of WHO. The preoperative and postoperative vertebral height was estimated on the lateral projection. All patients were followed up for six months at out-patient clinic or by telephone. Results The success rate of puncturing was 100%. The preoperative mean VAS was 6.9 ± 0.9. The postoperative VAS at one day, one, 3 and 6 months after the procedure was 5.0 ± 0.9, 3.5 ± 0.7, 2.5 ± 0.8 and 1.6 ± 0.7 respectively. Based on WHO pain degree classification standard, complete remission (CR) was obtained in 25 cases, partial remission (PR) in 3 cases, and invalid in 2 cases. The effective rate (CR +PR) was 93.33%. The mean preoperative height of the compressed vertebrae was (5.77 ± 1.09) mm and the mean postoperative height of the compressed vertebrae was (14.33 ± 2.03) mm. Conclusion For the treatment of severe vertebral compression fractures, percutaneous vertebroplasty is clinically feasible with reliable short-term effect.

BACKGROUND:Percutaneous vertebraplasty is a new means for the treatment of vertebral compression fractures and bone metastases. The multiplaner reconstruction with digital substraction angiography (DSA)-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, which can effectively prevent the leakage of bone cement. OBJECTIVE:To explore the value of DSA-Innova 3D in the guidance of puncture of percutaneous vertebroplasty. METHODS:From March 2014 to September 2014, a total of 72 patients with 94 vertebras were selected for percutaneous vertebraplasty, of whom 36 (48 vertebras) with Innova 3D (experimentalgroup) and 36 (46 vertebras) without Innova 3D (control group). Spiral CT scan was performed in al patients to assess the distribution of bone cement. The imaging quality in the two groups was compared by Mann-Whitney U test. RESULTS AND CONCLUSION:CT showed bone cement leakage occurred in 7 of the 36 patients in the control group. Leakages were into the lumber disc in two cases, paravertebral space in two cases, vertebral pedicle in onecase or veins in two cases. However, only one case of bone cement leakage was observed in the experimental group. With the guidance of DSA-Innova 3D, the experimental group had signficantly lower leakage and fluoroscopic time than the control group (P < 0.05). The multiplaner reconstruction with DSA-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, thereby effectively reducing the leakage of bone cement.

0.01). No serious complications occurred. Conclusion Both PLD+IDET and PLD are very effective in treating lumbar disc herniation. IDET is very helpful in relieving low back pain, although it can hardly improve patient's daily activities.