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E2268. Vertebral Intramedullary Air: Can it be Related to Anti-Angiogenic Drugs or Malignity
Authors
  1. Nazan Ciledag; Sbu Dr. Abdurrahman Yurtaslan Training Research Hospital
  2. Muhammed Goc; Sbu Dr. Abdurrahman Yurtaslan Training Research Hospital
  3. Burcu Savran; Sbu Dr. Abdurrahman Yurtaslan Training Research Hospital
  4. Hidir Kaygusuz; Sbu Dr. Abdurrahman Yurtaslan Training Research Hospital
  5. Abidin Kilic; Sbu Dr. Abdurrahman Yurtaslan Training Research Hospital
Objective:
Intramedullary air which is seen in the vertebrae with air radiodensity (-1000UH) unrelated to the joint space, is presented in individuals with a prevalence of 7-10%. This condition could be incidentally detected by CTs which are taken for different purposes. Etiology of intramedullary air could be various such as degenerative processes, osteonecrosis, osteomyelitis, post-operative and post-traumatic changes. We aim to investigate the relation of vertebral intramedullary air values detected by CT section with age, gender, localization, malignant processes, chemotherapy and radiotherapy.

Materials and Methods:
The study will be conducted retrospectively by the radiologists in our clinic. Images of the patients who had CT examination between 09.2019 – 09.2020 will be included in the study. Patients of both genders between the ages of 19 and 99 who were observed to have air values in the vertebrae in the neck, thorax, abdomen, pelvis, cervical, thoracic and lumbar CT examinations were included in the study. Not only the patients whose vertebral intramedullary air value had been thought to be related to the intervertebral space or degenerative processes but also the patients without vertebral air value were excluded from the study. In our study, we are going to evaluate the relationship of vertebral intramedullary air values seen in CT sections with age, gender, malignant processes, chemotherapy, radiotherapy and the segment we detected air values in.

Results:
During this period, we found intramedullary air value in 159 of the 2250 patients and we calculated the incidence as 7%. In this study, we indicated that 68 of these patients were male (42%) and 91 were female (48%). Malignancy was detected in 86 patients (54%), and there was no malignancy in 73 patients (46%). The most common malignancies were colon cancer with 16 patients and lung cancer with 9 patients. The lowest age was 28, the highest was 94, and the mean was calculated as 66.1. The mean age of malignant patients was 67.45 and the mean age of benign patients was 65.65. We detected intramedullary air value in thoracic vertebrae of 84 patients (52%), cervical vertebrae of 51 patients (26%), lumbar vertebrae of 27 patients (16%), sacrum of 4 patients (2%), costae of 11 patients (6%) and the other bones of 19 patients (11%). Fifty-six patients (35%) accounted that they had taken chemotherapy before; however, 97 patients did not have chemotherapy history (65%). Thirty patients stated that they had undergone radiotherapy.

Conclusion:
Intramedullary air value is a multifactorial process which includes degenerative processes, osteonecrosis, osteomyelitis, post-operative and post-traumatic changes in its etiology. We are going to evaluate the relationship of vertebral intramedullary air values with age, gender, malignant processes, chemotherapy, radiotherapy and the segment we detected air values in. We aim to investigate the relationship of this process with anti-angiogenic drugs and radiotherapy induced necrosis. We are planning to analyze the control images taken before and after chemotherapy.