Koizumi Yohei, Hirooka Masashi, Ochi Hironori, Tokumoto Yoshio, Takechi Megumi, Hiraoka Atsushi, Ikeda Yoshio, Kumagi Teru, Matsuura Bunzo, Abe Masanori, Hiasa Yoichi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan.
Department of Radiology, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan.
J Med Ultrason (2001). 2015 Apr;42(2):185-93. doi: 10.1007/s10396-014-0598-9. Epub 2014 Dec 18.
This study aimed at prospectively evaluating bile duct anatomy on ultrasonography and evaluating the safety and utility of radiofrequency ablation (RFA) assisted by virtual ultrasonography from gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI).
The institutional review board approved this study, and patients provided written informed consent prior to entry into the study. Bile duct anatomy was assessed in 201 patients who underwent Gd-EOB-DTPA-enhanced MRI for the evaluation of hepatic tumor. Eighty-one of these patients subsequently underwent RFA assisted by ultrasound imaging. In 23 patients, the tumor was located within 5 mm of the central bile duct, as demonstrated by MRI.
Virtual ultrasonography constructed by Gd-EOB-enhanced MRI was able to visualize the common bile duct, left hepatic duct, and right hepatic duct in 96.5, 94.0, and 89.6 % of cases, respectively. The target hepatic tumor nodule and biliary duct could be detected with virtual ultrasonography in all patients, and no severe complications occurred.
The running pattern of the bile ducts could be recognized on conventional ultrasound by referencing virtual ultrasonography constructed by Gd-EOB-DTPA-enhanced MRI. RFA assisted by this imaging strategy did not result in bile duct injury.
本研究旨在前瞻性评估超声检查中的胆管解剖结构,并评估基于钆塞酸二钠(Gd-EOB-DTPA)增强磁共振成像(MRI)的虚拟超声引导下射频消融(RFA)的安全性和实用性。
机构审查委员会批准了本研究,患者在进入研究前提供了书面知情同意书。对201例行Gd-EOB-DTPA增强MRI以评估肝肿瘤的患者进行胆管解剖结构评估。其中81例患者随后接受了超声成像引导下的RFA。MRI显示,23例患者的肿瘤位于中央胆管5mm范围内。
由Gd-EOB增强MRI构建的虚拟超声分别在96.5%、94.0%和89.6%的病例中能够显示胆总管、左肝管和右肝管。所有患者均能通过虚拟超声检测到目标肝肿瘤结节和胆管,且未发生严重并发症。
通过参考Gd-EOB-DTPA增强MRI构建的虚拟超声,可在传统超声上识别胆管走行模式。这种成像策略辅助的RFA未导致胆管损伤。