title: Partial splenic embolisation using n-butyl cyanoacrylate: intraprocedural evaluation by magnetic resonance imaging.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Immediate SI changes on DWI after PSE allowed semi-automated splenic volumetry on site.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Diagnostic Radiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa Prefecture 259-1193, Japan. jkoizumi@is.icc.u-tokai.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Koizumi
authors.forename: Chihiro
authors.initials: C
authors.lastname: Itou
authors.forename: Rick
authors.initials: R
authors.lastname: Wray
authors.forename: Kazunori
authors.initials: K
authors.lastname: Myojin
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Nagata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamuro
authors.forename: Tomoatsu
authors.initials: T
authors.lastname: Tsuji
authors.forename: Tamaki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Kouichi
authors.initials: K
authors.lastname: Shiraishi
authors.forename: Tatehiro
authors.initials: T
authors.lastname: Kagawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mine
authors.forename: Norihito
authors.initials: N
authors.lastname: Watanabe
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Matsumae
authors.forename: Bertrand
authors.initials: B
authors.lastname: Janne d'Othée
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D006971:Hypersplenism / Q000473:pathology* / Q000628:therapy*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D014014:Tissue Adhesives; D004659:Enbucrilate