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经动脉注射声诺维的超声造影增强成像在经动脉化疗栓塞术中的引导作用:初步经验

Contrast-enhanced ultrasonography with intraarterial administration of SonoVue for guidance of transarterial chemoembolization: an initial experience.

作者信息

Moschouris Hippocrates, Malagari Katerina, Kalokairinou Marianna, Stamatiou Konstantinos, Marinis Athanasios, Papadaki Marina Georgiou

机构信息

Department of Radiology, General Hospital Tzanio, Piraeus, Greece.

出版信息

Med Ultrason. 2011 Dec;13(4):296-301.


DOI:
PMID:22132402
Abstract

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..

摘要

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。

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[4]
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[6]
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[7]
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[8]
Use of transcatheter contrast-enhanced ultrasound with vessel navigation to reduce the contrast requirement during transarterial chemoembolization in patients with renal impairment.

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[9]
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[10]
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