Ultrasound monitoring of experimental ethanol injection into pig liver.
OBJECTIVE
In percutaneous ethanol injection therapy, uncontrolled spread of ethanol sometimes causes complications. This study tested the accuracy of ultrasonography in showing the spread of ethanol during injection in normal postmortem pig livers.


METHODS
Methylene blue-stained 96% (vol) ethanol (0.5-2 ml) was injected into pig livers under sonographic control. The volumes of the sonographically determined areas infiltrated by the injections and the corresponding pale lesions seen after dissecting the livers were measured and compared. The locations of the stained areas were determined.


RESULTS
Uncontrolled spread of ethanol was often seen sonographically as hyperechoic lines spreading centrifugally from the injection site. After dissection, nearly all vessels and ducts were stained blue, indicating a major escape of ethanol from the injection sites. The volumes of the sonographically determined injection areas were significantly larger (P < 0.001) than the lesions found after dissection.


CONCLUSIONS
Ultrasonography may overestimate the spread of ethanol, making the survival of peripheral tumor cells possible.
Tapani
E
E
Department of Radiology, Helsinki University Central Hospital, Finland.
Vehmas
T
T
Taavitsainen
M
M
D000279:Administration, Cutaneous; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D004396:Coloring Agents / Q000008:administration & dosage; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D000431:Ethanol / Q000008:administration & dosage*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging / Q000473:pathology; D066298:In Vitro Techniques; D008099:Liver / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology; D008751:Methylene Blue / Q000008:administration & dosage; D012044:Regression Analysis; D013552:Swine; D014463:Ultrasonography
D000970:Antineoplastic Agents; D004396:Coloring Agents; D000431:Ethanol; D008751:Methylene Blue