• Jo-Yu Chen, Fon-Yih Tsuang, Yen-Heng Lin, and Chung-Wei Lee.
• Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
• J Formos Med Assoc. 2025 Jan 24.

Background And PurposeDual-energy computed tomography (DECT) pulmonary angiography can reliably detect cement pulmonary embolisms (CPEs) and parenchymal perfusion defects. This prospective observational study investigated CPEs in asymptomatic patients using DECT.MethodsWe enrolled 42 patients who underwent vertebroplasty or received cement screws for vertebral augmentation, examining them using spinal computed tomography and DECT pulmonary angiography. An iodine map was employed to identify perfusion defects. We recorded the number, location, and perfusion defects of each CPE, and the vertebral cement distribution and perivertebral venous leakage patterns of prevertebral, paravertebral, epidural, and inferior vena cava leaks at each treated level. The presence of CPEs and perfusion defects was correlated with clinical factors and perivertebral venous leakage patterns in patient- and level-based analyses.ResultsSeven patients had 19 CPEs among them: fourteen in subsegmental arteries, two in segmental arteries, two in lobar arteries, and one in the main pulmonary artery. Twelve CPEs identified in four patients had corresponding perfusion defects on an iodine map. Patient-based univariable and multivariable logistic regression revealed that prevertebral leakage was significantly associated with the presence of CPEs (P < 0.05). Prevertebral leakage was significantly associated in the univariable analysis with the presence of perfusion defects (P = 0.025). In mixed-model univariable level-based logistic regression, prevertebral leakage was significantly associated with the presence of CPEs (P = 0.04).ConclusionsCPEs frequently occur following vertebral augmentation, are associated with substantial prevertebral venous leakage, and predominantly occur in the subsegmental pulmonary artery. They do not always cause perfusion defects.Copyright © 2025 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

3 keywords...

hide…