title: CT and radiographic appearance of extracranial Onyx(®) embolization.
abstract: Onyx(®) (ev3, Irvine, CA, USA) is a liquid embolic agent composed of ethylene vinyl alcohol copolymer dissolved in dimethyl sulphoxide used for the treatment of intracranial arteriovenous malformations. Onyx is a preferred embolizing agent due to its unique properties, non-adhesive nature, and durability. In addition to its approved intracranial application, Onyx is also being used successfully in extracranial embolization in areas including extracranial aneurisms and vascular malformations, trauma, gastrointestinal bleeding, and neoplasms. Because of its increasing utilization, it is important for reporting radiologists to be able to recognize its extracranial appearance across different imaging techniques and to be familiar with its uses. The goal of this review is to describe the extracranial uses of Onyx and its appearance in various extracranial locations at radiography and CT, while providing didactic examples. Onyx appears radiodense at CT and plain radiography and has a curvilinear pattern following the expected path of the vessel embolized. At CT, Onyx creates streak artefact that may obstruct the view of surrounding tissues consistent with descriptions of other tantalum devices.
authors.affiliation: Department of Radiological Sciences, University of California, Irvine, 101 The City Drive South, Route 140, Orange, CA 92868, USA. Electronic address: Jemiannb@uci.edu.
authors.forename: J B
authors.initials: JB
authors.lastname: Jia
authors.affiliation: Department of Radiological Sciences, University of California, Irvine, 101 The City Drive South, Route 140, Orange, CA 92868, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Green
authors.affiliation: Department of Radiological Sciences, University of California, Irvine, 101 The City Drive South, Route 140, Orange, CA 92868, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Cohen
authors.affiliation: Department of Radiological Sciences, University of California, Irvine, 101 The City Drive South, Route 140, Orange, CA 92868, USA.
authors.forename: M
authors.initials: M
authors.lastname: Helmy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D055815:Young Adult
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide