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Abstract(s)
A produção de calor devido ao efeito da polimerização do cimento ósseo pode resultar em danos irreversíveis de necrose térmica no tecido adjacente. No entanto, este fenómeno pode, em alguns casos, beneficiar clinicamente as situações patológicas. O objetivo deste trabalho é avaliar a minimização da evolução de sarcomas ósseos, através da injeção de ampolas de cimento ósseo que preencherão o espaço da lesão lítica tumoral.
Neste sentido, foi realizado um estágio de três meses no serviço de radiologia na clínica SMIC Boavista no Porto para uma melhor aprendizagem das metodologias clínicas, interpretação e recolha de algumas imagens médicas. Em simultâneo, foram também recolhidas imagens médicas no serviço de Ortopedia do Centro Hospitalar do Porto (CHP). Através da avaliação prévia dessas imagens médicas por grupos de análise (género, idade, órgão afetado e patologia associada) foram desenvolvidos modelos computacionais.
Pretende-se assim efetuar uma avaliação do efeito benéfico da produção de calor em tecidos com sarcoma, recorrendo à injeção de cimento ósseo, através do desenvolvimento de diferentes modelos computacionais para análise térmica em regime transiente. Foram utilizados quatro diferentes cimentos ósseos, sendo um deles um cimento utilizado no serviço de Ortopedia no CHP. Este trabalho permitiu obter uma discussão de resultados, para que em conjunto com o CHP, exista uma melhor perceção na utilização do cimento ósseo no tratamento de lesões tumorais.
Como conclusões gerais, a maior temperatura e a necrose térmica ocorrem na interface cimento-osso-tumor na presença de uma haste intramedular. O preenchimento com um cimento ósseo de menor viscosidade e a estabilização estrutural com uma haste intramedular de titânio em ossos longos, podem traduzir-se numa aplicação cujo objetivo clínico seja o tratamento de lesões líticas metastáticas para o controlo local do crescimento tumor.
The heat generation due to the effect of the bone cement polymerization can result in irreversible damages of thermal necrosis in the adjacent tissue. However, in some situations, this phenomenon could have clinically advantages. The main objective of this study is to evaluate the minimization of bone sarcomas by injecting bone cement and filling the space of the tumor lithic lesion. According to this project, an internship of three months was carried out in the clinic radiology service at SMIC Boavista for a better learning of the clinical approaches, interpretation and collection of some medical images. In simultaneous, others medical images were collected at the Orthopaedics Service of the Hospital Centre of Porto (CHP). Through the previous evaluation of the medical images in groups of analysis (gender, age, affected organ and associated pathology) different computational models were developed. It is intended to obtain an evaluation of the useful effect of heat generation on tissues with sarcoma using different computational models for transient thermal analysis. Four different bone cements were considered, one of which is a bone cement used clinically in the CHP. This work allowed to obtain a discussion of results, that in conjunction with CHP could allow for a better understanding to the use of bone cement in the tumor lesions treatment. As general conclusions, the high temperature and the thermal necrosis occur in the cement-bone-tumor interface in the presence of intramedullary nail. The bone cement filling with lower viscosity and the structural stabilization of long bones with intramedullary titanium stem, could be applied as a clinical objective to the treatment of metastatic lytic lesions in confined control tumor growing.
The heat generation due to the effect of the bone cement polymerization can result in irreversible damages of thermal necrosis in the adjacent tissue. However, in some situations, this phenomenon could have clinically advantages. The main objective of this study is to evaluate the minimization of bone sarcomas by injecting bone cement and filling the space of the tumor lithic lesion. According to this project, an internship of three months was carried out in the clinic radiology service at SMIC Boavista for a better learning of the clinical approaches, interpretation and collection of some medical images. In simultaneous, others medical images were collected at the Orthopaedics Service of the Hospital Centre of Porto (CHP). Through the previous evaluation of the medical images in groups of analysis (gender, age, affected organ and associated pathology) different computational models were developed. It is intended to obtain an evaluation of the useful effect of heat generation on tissues with sarcoma using different computational models for transient thermal analysis. Four different bone cements were considered, one of which is a bone cement used clinically in the CHP. This work allowed to obtain a discussion of results, that in conjunction with CHP could allow for a better understanding to the use of bone cement in the tumor lesions treatment. As general conclusions, the high temperature and the thermal necrosis occur in the cement-bone-tumor interface in the presence of intramedullary nail. The bone cement filling with lower viscosity and the structural stabilization of long bones with intramedullary titanium stem, could be applied as a clinical objective to the treatment of metastatic lytic lesions in confined control tumor growing.
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Keywords
Sarcoma Tumor ósseo Cimento ósseo Modelo térmico