Aoki S, Terada H, Kosuda S, Shitara N, Fujii H, Suzuki K, Kutsukake Y, Tanaka J, Sasaki Y, Okubo T
Department of Radiology, Tokyo Metropolitan Komagome Hospital, Japan.
Radiology. 1993 Aug;188(2):347-50. doi: 10.1148/radiology.188.2.8327676.
Supraophthalmic intraarterial chemotherapy has not become popular due to a high incidence of damage to the normal brain and eye. This damage is due to inhomogeneous distribution of the agent secondary to streaming and other flow-related phenomena. To try to minimize this complication, the authors developed a catheter and studied different infusion techniques. A 4.5-F catheter tapered to 2.5 F was used to perform supraophthalmic intraarterial chemotherapy in 26 patients with malignant gliomas. Forty-one of 45 catheterizations were successful. In 17 patients (20 procedures), technetium-99m hexamethyl-propyleneamine oxime (HMPAO) was then injected through the catheter and single photon emission computed tomography was performed to assess the cerebral distribution of the radiopharmaceutical with either a pulsatile or continuous infusion technique. Diffuse and relatively homogeneous distribution of Tc-99m HMPAO was observed with fast pulsatile infusion (10 of 10 procedures); however, inhomogeneous distribution was mostly seen with slow continuous infusion (eight of 10 procedures).
由于对正常脑和眼的损伤发生率较高，经眼动脉内化疗尚未普及。这种损伤是由于药物在血流和其他与血流相关现象作用下分布不均匀所致。为尽量减少这种并发症，作者研发了一种导管并研究了不同的灌注技术。使用一根逐渐变细至2.5F的4.5F导管，对26例恶性胶质瘤患者进行经眼动脉内化疗。45次插管中有41次成功。然后，在17例患者（20次操作）中，通过导管注入锝-99m六甲基丙烯胺肟（HMPAO），并采用脉冲式或连续灌注技术进行单光子发射计算机断层扫描，以评估放射性药物在脑内的分布情况。快速脉冲式灌注时观察到Tc-99m HMPAO呈弥漫性且相对均匀的分布（10次操作中有10次）；然而，缓慢连续灌注时大多出现不均匀分布（10次操作中有8次）。
