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

Jun Koizumi, Chihiro Itou, Rick Arthur Wray, Kazunori Myojin, Takeshi Hashimoto, Yoshimi Nagata, Hiroshi Yamamuro, Tomoatsu Tsuji, Tamaki Ichikawa, Kouichi Shiraishi, Tatehiro Kagawa, Tetsuya Mine, Norihito Watanabe, Mitsunori Matsumae, Bertrand Janne D'Othée

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1429-1442
Number of pages14
JournalEuropean Radiology
Volume23
Issue number5
DOIs
StatePublished - May 1 2013
Externally publishedYes

    Fingerprint

Keywords

  • Computed tomography
  • Diffusion-weighted image
  • n-butyl cyanoacrylate
  • Partial splenic embolisation
  • Volumetry

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Koizumi, J., Itou, C., Wray, R. A., Myojin, K., Hashimoto, T., Nagata, Y., Yamamuro, H., Tsuji, T., Ichikawa, T., Shiraishi, K., Kagawa, T., Mine, T., Watanabe, N., Matsumae, M., & D'Othée, B. J. (2013). Partial splenic embolisation using n-butyl cyanoacrylate: Intraprocedural evaluation by magnetic resonance imaging. European Radiology, 23(5), 1429-1442. https://doi.org/10.1007/s00330-012-2711-z