Jiang Yuan Yuan, Jo Ye-Eun, Woo Jung Min, Lim Ok Kyun, Hwang Changmo, Maeng Jun Young, Kim Jieun, Kim Namkug, Lee Deok Hee
Department of Medical Biotechnology, Dongguk University, Ilsan, Korea.
Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Neurointervention. 2017 Mar;12(1):3-10. doi: 10.5469/neuroint.2017.12.1.3. Epub 2017 Mar 6.
Onyx has been successfully applied in the treatment of various neurovascular lesions. However, some experience is required to get accustomed to its unpredictable fluoroscopic visibility during injection. This study aimed to evaluate the characteristics of radiopacity change in a simulated embolization procedure.
Using a bench-top Onyx injection experiment simulating a typical brain arteriovenous malformation embolization, nine cycles of casting modes (continuous injection) and plugging modes (injection with intermittent pauses) were performed. Radiodensity of Onyx droplets collected from the microcatheter tip and the distal head portion of the microcatheter were measured as time lapsed. Distribution of droplet radiodensity (radiodensity) and distribution of radiographic grade (grade) were analyzed and compared by repeated measurements.
Within-group analysis revealed no significant radiodensity change with time (P>0.05). The radiodensity was significantly higher in the casting mode than in the plugging mode (P<0.01). The lateral radiograph of the microcatheter showed higher radiopacity (P<0.01) and better evenness (P<0.01) in the casting mode than in the plugging mode. A significant difference in microcatheter attenuation (both radiographic grade mean and SD; P<0.01) was noted between the two modes. Radiodensity had a significant influence on the radiopacity and radiopacity evenness of the microcatheter.
The radiopacity of the Onyx can vary significantly over time because of early precipitation of tantalum powder. Radiopacity decreased significantly during plugging modes, characterized by pauses between injections.
Onyx已成功应用于各种神经血管病变的治疗。然而，在注射过程中需要一些经验来适应其不可预测的荧光透视可见性。本研究旨在评估模拟栓塞过程中造影剂不透光性变化的特征。
通过台式Onyx注射实验模拟典型的脑动静脉畸形栓塞，进行了九个周期的铸型模式（连续注射）和封堵模式（间歇注射）。随着时间的推移，测量从微导管尖端和微导管远端头部收集的Onyx液滴的放射密度。通过重复测量分析和比较液滴放射密度分布（放射密度）和放射学分级分布（分级）。
组内分析显示放射密度随时间无显著变化（P>0.05）。铸型模式下的放射密度显著高于封堵模式（P<0.01）。微导管的侧位X线片显示，铸型模式下的造影剂不透光性更高（P<0.01），均匀性更好（P<0.01）。两种模式之间微导管衰减存在显著差异（放射学分级均值和标准差均为P<0.01）。放射密度对微导管的造影剂不透光性和不透光性均匀性有显著影响。
由于钽粉的早期沉淀，Onyx的造影剂不透光性可能随时间显著变化。在封堵模式（以注射间歇为特征）下，造影剂不透光性显著降低。
