Moschouris Hippocrates, Malagari Katerina, Kalokairinou Marianna, Stamatiou Konstantinos, Marinis Athanasios, Papadaki Marina Georgiou
Department of Radiology, General Hospital Tzanio, Piraeus, Greece.
Med Ultrason. 2011 Dec;13(4):296-301.
AIMS: To describe the technique and to evaluate the feasibility of contrast-enhanced ultrasound with intraarterial administration of echo-enhancer (i.a CEUS) as a method for guidance of transarterial chemoembolization (TACE). PATIENTS AND METHODS: Twelve patients with 17 target liver tumors underwent superselective TACE, guided with i.a CEUS. After microcatheter placement in a (sub)segmental artery suspected as a tumor feeder, a diluted suspension of SonoVue was injected through the microcatheter, and imaging of the target tumor was performed with a low mechanical index technique and with contrast-specific software. If intraarterial injection of SonoVue was associated with immediate, strong tumoral enhancement, the injected artery was considered as tumor-feeding and TACE was performed, otherwise another artery was evaluated. RESULTS: From 25 segmental or subsegmental arteries evaluated i.a CEUS confirmed that 16 arteries were actually tumor feeders and unequivocal excluding 4 arteries as a tumor arterial supply. The remainder 5 arterial branches could not be safely characterized due to artifacts or technical limitations. In 8 patients in which tumoral vascular supply could not be elucidated by angiography alone, i.a CEUS increased the accuracy of supereselective embolization, and provided other clinically relevant information in 2 of these patients. No adverse effects were observed. CONCLUSIONS: For guidance of superselective TACE i.a CEUS is a safe and feasible method..
目的:描述经动脉注射超声造影剂增强超声检查(动脉内CEUS)技术,并评估其作为肝动脉化疗栓塞术(TACE)引导方法的可行性。 患者与方法:12例患者共17个肝脏靶肿瘤接受了在动脉内CEUS引导下的超选择性TACE。在将微导管置于疑似肿瘤供血的(亚)段动脉后,通过微导管注射稀释的声诺维混悬液,采用低机械指数技术和造影剂特异性软件对靶肿瘤进行成像。如果经动脉注射声诺维后肿瘤立即出现强烈强化,则认为该动脉为肿瘤供血动脉并进行TACE,否则评估另一动脉。 结果:在经动脉内CEUS评估的25条段或亚段动脉中,证实16条动脉实际为肿瘤供血动脉,明确排除4条动脉为肿瘤供血。其余5条动脉分支因伪像或技术限制无法安全判断。在8例仅通过血管造影无法明确肿瘤血管供应的患者中,动脉内CEUS提高了超选择性栓塞的准确性,并在其中2例患者中提供了其他临床相关信息。未观察到不良反应。 结论:对于超选择性TACE的引导,动脉内CEUS是一种安全可行的方法。
Cardiovasc Intervent Radiol. 2010-6-16
World J Radiol. 2020-8-28