Intraosseous pressure measurement of cystic bone lesions and comparison with normal marrow.

OBJECTIVE

To (1) measure intraosseous pressure (IOP) in cystic bone lesions and compare it with pressure values in normal bone marrow from a previous cohort; (2) to investigate the relationship between intralesional and systemic blood pressure.

MATERIALS AND

METHODS

In this prospective HIPAA-compliant study, patients referred for CT-guided sclerotherapy of cystic bone lesions or CT-guided bone marrow biopsy between November 2020 and February 2022 were consecutively enrolled. IOP was recorded in vivo through the biopsy needle using a closed arterial pressure monitoring system for 5 min. Demographic variables and systemic blood pressure were collected. Continuous and categorical variables were compared using the Student t test and Fisher's exact test, respectively. Pearson correlation was used to assess the relationship between intraosseous and systemic blood pressure. A p value < 0.05 was considered statistically significant.

RESULTS

Seven patients with cystic bone lesions (CBL) and 45 patients with normal marrow histology were included. Participants with CBL were younger than those in the normal marrow group (20 ± 4 vs 55 ± 14 years; p < 0.001) and had lower mean arterial pressure (80 ± 11 vs 93 ± 13 mmHg; p = 0.02). Systolic intraosseous pressures were significantly higher in cystic lesions (90 ± 18 mm Hg vs. 67 ± 23 mm Hg, p = 0.01). There was no significant correlation between systemic blood pressure and intraosseous pressure (all p > 0.35).

CONCLUSION

Cystic bone lesions demonstrate elevated intraosseous pressures, particularly systolic parameters, compared with normal marrow. Intraosseous pressures appear independent of systemic blood pressure.