用于经导管栓塞治疗的“可成像”微球的研制。
Development of "imageable" beads for transcatheter embolotherapy.
机构信息
Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
出版信息
J Vasc Interv Radiol. 2010 Jun;21(6):865-76. doi: 10.1016/j.jvir.2010.02.031.
PURPOSE
To develop and characterize radiopaque embolization microspheres capable of in vivo detection with intraprocedural fluoroscopy and computed tomography (CT) imaging and to evaluate their spatial distribution inside target tissues during and after transcatheter embolization.
MATERIALS AND METHODS
Polyvinyl alcohol hydrogel microspheres were loaded with Lipiodol and examined for iodine content, stability of loading, and conspicuity with fluoroscopy and CT in vitro. Transcatheter embolization of swine liver and kidney was performed with the radiopaque microspheres and spatial distribution was evaluated with intraprocedural fluoroscopy and CT. Ex vivo evaluation was performed with light microscopy and micro-CT.
RESULTS
In vitro analyses demonstrated that radiopaque microspheres could be loaded with sufficient iodine content to be detected with routine fluoroscopy and CT imaging and that such loading was relatively stable. Radiopaque microspheres were visible in vivo with fluoroscopy and CT during transcatheter embolization. CT imaging during embolization procedures demonstrated a dose-dependent relationship in the number and size of visualized embolized arteries. Imaging features of radiopaque microsphere distribution inside target tissues correlated well with ex vivo light microscopic and micro-CT evaluation of microsphere distribution.
CONCLUSIONS
Radiopaque embolization microspheres are visualized during transcatheter embolization with routine intraprocedural fluoroscopy and CT. These radiopaque microspheres provided the three-dimensional spatial distribution of embolic material inside target organs during the procedure, and therefore can provide real-time intraprocedural feedback for the interventional radiologist. These microspheres may be useful for demonstrating the influence of material and technical variability in transcatheter embolization in addition to providing intraprocedural identification of tissue at risk of undertreatment.
目的
开发和表征能够在体内用术中透视和计算机断层扫描（CT）成像检测的不透射线栓塞微球，并评估其在经导管栓塞过程中和之后在靶组织内的空间分布。
材料和方法
将聚乙烯醇水凝胶微球加载碘油，并对其碘含量、负载稳定性以及在体外透视和 CT 中的显影性进行评估。用不透射线微球进行猪肝和肾的经导管栓塞，并在术中用透视和 CT 评估其空间分布。进行离体评估，采用光学显微镜和微 CT。
结果
体外分析表明，不透射线微球可以负载足够的碘含量，以便用常规透视和 CT 成像检测，并且这种负载相对稳定。在经导管栓塞过程中，不透射线微球在透视和 CT 下在体内可见。栓塞过程中的 CT 成像显示，可见的栓塞动脉的数量和大小与剂量呈依赖性关系。不透射线微球在靶组织内分布的成像特征与离体光学显微镜和微 CT 评估的微球分布具有良好的相关性。
结论
不透射线栓塞微球在经导管栓塞过程中用常规术中透视和 CT 可见。这些不透射线微球提供了栓塞材料在靶器官内的三维空间分布，因此可以为介入放射科医生提供实时术中反馈。这些微球除了提供术中识别治疗不足的组织外，还可能有助于显示经导管栓塞中材料和技术变化的影响。
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