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Reply to Preoperative MR Findings Predictive of Cement Leakage During Vertebroplasty: Low Signal Intensity Linear Lesion in Intervertebral Disk

Kyushu University Fukuoka, Japan

Per-Lennart Westesson

University of Rochester Medical Center Rochester, NY

WEB—This is a Web exclusive article.

We appreciate the comments from Dr. Lee and colleagues [1] regarding our article [2]. We are pleased that they share the same idea that preoperative MRI may predict cement leakage. There are differences between the observations in our study and the study by Lee et al. [3]. They saw linear low signal on T1- and T2-weighted images in the disk. They found high sensitivity of linear low signal on T2-weighted images and high specificity of low signal on T1- and T2-weighted images. Lee et al. did not elaborate on an explanation for the low signal intensity in the disk. In our opinion, it probably represents the so-called "vacuum phenomenon" that is seen in the severe degenerative disease.

In our study [2], we found T2 hyperintensity in the degenerated disk adjacent to the fractured vertebral body to predict the risk of cement leakage. This hyperintensity probably represents damage to the disk. We think that this signal change can also represent a communication to the bone marrow of the vertebral body. This is the way the cement travels from the bone marrow to the disk. Overall, we think that both studies look at the same thing—that MRI can predict where cement leakage is likely to occur. We thank Dr. Lee and his colleagues for their interest in our study and their valuable comments.

References

1. Yoo DS, Kim YM, Lee YS. Preoperative findings predictive of cement leakage during vertebroplasty: low signal intensity linear lesion in intervertebral disk (letter). AJR 2007;189 : [web]W302
2. Hiwatashi A, Ohgiya Y, Kakimoto N, Westesson PL. Cement leakage during vertebroplasty can be predicted on preoperative MRI. AJR 2007; 188:1089 –1093[Abstract/Free Full Text]
3. Lee KH, Yoo DS, Kim YM, Lee YS. MR findings predictive of intradiscal leakage of bone cement in vertebroplasty. J Korean Radiol Soc 2007; 56:371 –377

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hiwatashi, A. Articles by Westesson, P.-L. Search for Related Content PubMed PubMed Citation Articles by Hiwatashi, A. Articles by Westesson, P.-L. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?