Partial splenic embolisation using n-butyl cyanoacrylate: intraprocedural evaluation by magnetic resonance imaging.

Autor: Koizumi, Jun, Itou, Chihiro, Wray, Rick, Myojin, Kazunori, Hashimoto, Takeshi, Nagata, Yoshimi, Yamamuro, Hiroshi, Tsuji, Tomoatsu, Ichikawa, Tamaki, Shiraishi, Kouichi, Kagawa, Tatehiro, Mine, Tetsuya, Watanabe, Norihito, Matsumae, Mitsunori, Janne d'Othée, Bertrand
Zdroj: European Radiology; May2013, Vol. 23 Issue 5, p1429-1442, 14p
Abstrakt: Objectives: To evaluate the use of diffusion-weighted imaging (DWI) for estimating infarcted splenic volume during partial splenic embolisation (PSE) using n-butyl cyanoacrylate (NBCA).Methods: Twenty consecutive patients (57.2 ± 11.7 years) with hypersplenism underwent PSE. Intrasplenic branches were embolised using NBCA via a 2.1-French microcatheter aiming at infarction of 50 to 80 % of total splenic volume. Immediately after PSE, signal intensities (SI) of embolised and non-embolised splenic parenchyma were measured on DWI. Semi-automated volumetry (SAV) on DWI was compared with conventional manual volumetry (MV) on contrast-enhanced CT 1 week after PSE. Platelet counts were recorded before and after PSE.Results: The SI on DWI in the embolised parenchyma decreased significantly (P < 0.01) to 24.7 ± 8.1 % as compared to non-embolised parenchyma. SAV and MV showed a strong correlation (r = 0.913 before PSE, r = 0.935 after PSE, P < 0.01) and significant (P < 0.01) reduction of normal splenic volume was demonstrated on both SAV (71.9 ± 12.4 %) and MV (73.6 ± 9.3 %) after PSE. Based on the initial SAV, three patients (15 %) underwent additional branch embolisation to reach sufficient infarction volume. Platelet counts elevated significantly (522.8 ± 209.1 %, P < 0.01) by 2 weeks after PSE. No serious complication was observed.Conclusion: Immediate SI changes on DWI after PSE allowed semi-automated splenic volumetry on site.Key Points: • Partial splenic embolisation (PSE) is an important interventional technique for hypersplenism • Diffusion-weighted MR reveals an immediate decrease in signal in the embolised parenchyma • Such signal reduction permits semi-automated splenic volumetry on site. • This allows precise quantification of the amount of parenchyma infarcted, avoiding additional PSE. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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