使用计算机断层扫描评估孤立胰腺灌注化疗的可行性：猪模型的实验研究

Evaluating the Feasibility of Isolated Pancreatic Perfusion for Chemotherapy Using Computed Tomography: An Experimental Study in Pig Models.

作者信息

Murata Satoru, Onozawa Shiro, Yasui Daisuke, Ueda Tatsuo, Sugihara Fumie, Shimizu Akira, Suzuki Kenichi, Satake Mitsuo

机构信息

Radiology/Center for Interventional Radiology, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan.

Departments of Radiology, Teikyo University Mizonokuchi Hospital, 5-1-1 Futago, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan.

出版信息

Cardiovasc Intervent Radiol. 2018 Jul;41(7):1081-1088. doi: 10.1007/s00270-018-1943-y. Epub 2018 Mar 26.

DOI:10.1007/s00270-018-1943-y

PMID:29582129

Abstract

PURPOSE

Percutaneous isolated pancreatic perfusion (PIPP) is performed along with interventional radiology techniques to obtain high drug concentration by occluding the arterial inlet and venous outlet of the pancreas. The experimental study aimed to evaluate the contrast distribution in PIPP under different flow rates with or without anterior mesenteric artery (AMA) occlusion.

MATERIALS AND METHODS

This study was approved by a local animal experiment ethics committee. Nine pigs were divided into Groups 1, 2, and 3, by infusion rates of 12, 24, and 36 mL/min. Groups 4 and 5 (3 pigs each) and Group 6 (2 pigs) underwent PIPP at the same respective infusion rates with and without AMA occlusion. Computed tomography (CT) arteriography was performed during PIPP with nonionic contrast media. The enhanced volume was calculated by adding the enhanced area in each slice using 1.25-mm axial images. The percent enhanced volume to the whole pancreas (%eV) was used to simulate drug distribution; the result was compared among groups.

RESULTS

Without AMA occlusion, a larger %eV was obtained with high infusion rates (P = 0.039). The median %eV in Groups 1, 2, and 3 were 57.7, 74.2, and 90.5%, respectively. With AMA occlusion, CT demonstrated duodenal enhancement at an infusion rate of 36 mL/min, and the median %eV in Groups 4, 5, and 6 were 92.8, 95.4, and 98.5%, respectively. A significantly larger %eV was obtained after AMA occlusion (P = 0.031).

CONCLUSION

A higher infusion rate or AMA occlusion increases the enhanced volume in PIPP in pig models.

LEVEL OF EVIDENCE

No level of evidence.

摘要

目的

经皮孤立胰腺灌注（PIPP）与介入放射学技术联合应用，通过阻断胰腺的动脉入口和静脉出口来获得高药物浓度。本实验研究旨在评估在不同流速下，有或无肠系膜前动脉（AMA）阻断时PIPP中的造影剂分布情况。

材料与方法

本研究经当地动物实验伦理委员会批准。将9头猪按输注速率分为1、2、3组，输注速率分别为12、24和36 mL/min。4组和5组（每组3头猪）以及6组（2头猪）分别在相同的输注速率下进行有或无AMA阻断的PIPP。在PIPP期间使用非离子型造影剂进行计算机断层扫描（CT）血管造影。使用1.25 mm轴向图像，通过将每一层的增强面积相加来计算增强体积。用增强体积占整个胰腺的百分比（%eV）来模拟药物分布；对各组结果进行比较。

结果

在无AMA阻断时，高输注速率可获得更大的%eV（P = 0.039）。1、2、3组的%eV中位数分别为57.7%、74.2%和90.5%。在有AMA阻断时，CT显示在输注速率为36 mL/min时十二指肠增强，4、5、6组的%eV中位数分别为92.8%、95.4%和98.5%。AMA阻断后获得的%eV显著更大（P = 0.031）。