Vollherbst Dominik F, Otto Ruth, Do Thuy, Kauczor Hans U, Bendszus Martin, Sommer Christof M, Möhlenbruch Markus A
1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
2 Clinic for Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany.
Interv Neuroradiol. 2018 Dec;24(6):693-701. doi: 10.1177/1591019918782692. Epub 2018 Jul 4.
A frequently reported drawback of ethylene vinyl alcohol copolymer-based liquid embolic agents is the production of artifacts in diagnostic imaging. New embolic agents, such as Precipitating hydrophobic injectable liquid (PHIL; MicroVention, Tustin, CA, USA), are supposed to induce significantly fewer artifacts. The purpose of this study is to assess the degree of artifacts induced by the liquid embolic agents Onyx (Medtronic Neurovascular, Irvine, CA, USA) and PHIL in conventional computed tomography (CT), cone-beam CT and magnetic resonance imaging (MRI) in an experimental in vivo model.
In 10 pigs the rete mirabile was embolized with Onyx ( n = 5) or PHIL ( n = 5). After embolization, conventional CT, cone-beam CT and MRI were performed. The degree of artifacts was graded qualitatively (five-point scale; for CT and MRI) and quantitatively (HUs of well-defined regions of interest (ROIs); for CT only).
Artifacts were significantly more severe for Onyx both in the qualitative (e.g. conventional CT: 2 versus 5 (medians); p = 0.008) and in the quantitative image analysis (e.g. cone-beam CT: standard deviation of a ROI near to the embolic agent cast, 94 HU versus 38 HU (medians); p = 0.008). Neither Onyx nor PHIL produced any apparent artifacts in MRI.
PHIL produces fewer artifacts than Onyx in conventional CT and cone-beam CT in an experimental in vivo model.
基于乙烯-乙烯醇共聚物的液体栓塞剂一个经常被报道的缺点是在诊断成像中会产生伪影。新型栓塞剂，如沉淀型疏水可注射液体（PHIL；美国加利福尼亚州图斯廷市MicroVention公司），据推测产生的伪影要少得多。本研究的目的是在实验性体内模型中评估液体栓塞剂Onyx（美国美敦力神经血管公司，加利福尼亚州欧文市）和PHIL在传统计算机断层扫描（CT）、锥束CT和磁共振成像（MRI）中所诱发的伪影程度。
对10头猪的奇网进行栓塞，其中5头用Onyx栓塞，5头用PHIL栓塞。栓塞后，进行传统CT、锥束CT和MRI检查。对伪影程度进行定性分级（五分制；用于CT和MRI）和定量分级（明确感兴趣区域（ROI）的HU值；仅用于CT）。
无论是定性分析（如传统CT：中位数为2级对5级；p = 0.008）还是定量图像分析（如锥束CT：靠近栓塞剂铸型的ROI的标准差，中位数为94 HU对38 HU；p = 0.008），Onyx产生的伪影都明显更严重。在MRI中，Onyx和PHIL均未产生任何明显伪影。
在实验性体内模型中，在传统CT和锥束CT方面，PHIL产生的伪影比Onyx少。
