Shiono T, Yoshikawa K, Hisamatsu K, Takenaka E
Department of Radiology, Kanto Rosai Hospital, Kawasaki, Japan.
Radiat Med. 1993 Sep-Oct;11(5):187-90.
We evaluated the clinical efficacy of an embolizing emulsion produced by mixing lipiodol and Gd-DTPA, in transcatheter arterial chemoembolization (TAE). Subjects were 10 patients with hepatocellular carcinoma (HCC). The emulsion used was produced by mixing 3 ml of lipiodol and anticancer agents (mitomycin-C 10 mg and adriamycin 20 mg) dissolved in Gd-DTPA. This emulsion was infused into the proper hepatic artery. Subsequent embolization by Gelfoam was performed in eight patients. MRI and CT examinations were performed soon after TAE (1 or 2 days after) and two weeks afterwards. The position of lipiodol accumulation dipicted on CT at two weeks after TAE did not differ from the site of change in signal intensity induced by Gd-DTPA on MR images soon after TAE in any case. In almost all cases, the washout of Gd-DTPA occurred earlier than that of lipiodol. It might be suggested that Gd-DTPA, which is water-soluble, shows in vivo dynamics similar to anticancer agents rather than to lipiodol, which is oil-soluble. Since the normal tissues showed no definite signal changes, we could easily detect the site of tumors by using the emulsion containing Gd-DTPA even on MR studies immediately after TAE. In addition, the deposits of Gd-DTPA depicted on MR images created fewer artifacts than the lipiodol deposits on CT.
我们评估了在经导管动脉化疗栓塞术（TAE）中，由碘油与钆喷酸葡胺混合制成的栓塞乳剂的临床疗效。研究对象为10例肝细胞癌（HCC）患者。所用乳剂是将3 ml碘油与溶解于钆喷酸葡胺中的抗癌药物（丝裂霉素-C 10 mg和阿霉素20 mg）混合制成。将该乳剂注入肝固有动脉。8例患者随后用明胶海绵进行栓塞。在TAE后不久（1或2天后）以及两周后进行了MRI和CT检查。在任何情况下，TAE后两周CT上显示的碘油聚集位置与TAE后不久MR图像上钆喷酸葡胺诱导的信号强度变化部位并无差异。在几乎所有病例中，钆喷酸葡胺的洗脱比碘油更早发生。这可能表明，水溶性的钆喷酸葡胺在体内的动态变化与抗癌药物相似，而非与油溶性的碘油相似。由于正常组织未显示明确的信号变化，即使在TAE后立即进行MR检查时，我们使用含钆喷酸葡胺的乳剂也能轻松检测出肿瘤部位。此外，MR图像上显示的钆喷酸葡胺沉积物产生的伪影比CT上的碘油沉积物少。
