化学位移成像对MR导引VX2兔化学消融监控的实验研究
摘要
目的:肝癌是我国十分常见的恶性肿瘤,发病率和死亡率一直居高不下,外科手术和肝移植可能提供治愈肝癌的机会,但是手术的适应症比较局限,绝大多数患者不适于这两种方法的治疗。最近多种微创,包括:栓塞化疗、射频消融、激光诱导的热治疗和用无水乙醇或乙酸的化学消融等非手术局部治疗已经被报道。对小肝癌(小于3cm)行化学消融5年生存率能达到60%,可以和外科手术相当。最近的任意,随机对照实验研究显示:乙酸对小肝癌患者的化学消融治疗比无水乙醇更有效,但乙酸肾毒性的副作用限制了它的应用。无水乙醇治疗小肝癌受到了人们的重视,取得了一致公认的疗效,副作用相对小。化学消融绝大多数通常是应用B超或CT作为导引手段来执行的。遗憾的是,这些设备不能直接使注射的化学试剂成像。而注射的容量主要由肿瘤的形态和大小决定. B超或CT通常难以精确评估肿瘤灭活范围,由此我们通过试验研究探讨化学位移成像对MR导引VX2兔化学消融监控的价值。
方法:
1、肝VX2瘤兔制备.采用包埋法将肿瘤种植在新西兰大白兔肝脏,种植3周后,全麻下行MRI扫描。1.5T超导磁共振扫描仪,头颈联合8通道线圈,常规:SE T1WI,FSPGR T1WI,FRFSE T2WI扫描,证实肿瘤种植成功。2只VX2瘤兔扫描后,处死,用于病理检查。余兔行MRI导向经皮穿刺化学消融注射术。
2、磁共振介入技术:采用快速翻转快速自旋回波序列(FRFSE)作为监视手段,在闭孔式1.5T超导磁共振扫描仪上进行定位穿刺, MRI扫描监控穿刺针方向和深度,当MRI扫描证实穿刺针针尖插入病灶内即可行PEI治疗。
3、化学位移磁共振成像:应用FRFSE T2WI序列同时采用选择性化学选择饱和磁共振组织抑制技术,将波谱频率中心调到以乙酸甲基H质子的共振频率(-170HZ)或无水乙醇甲基H质子的共振频率(大约-240 HZ),同时进行水饱和抑制以压制水共振的信号进行化学位移成像来完成对试验模型及PEI消融VX2肝肿瘤术中的扫描。
结果
1、在对VX2兔PEI时,T2加权像,在治疗后有多种信号改变,利用乙醇治疗前后的信号变化,无水乙醇分布范围与病理上肿瘤的坏死范围有正相关性,相关有统计学意义。
2、50%乙酸注射的相关部位信号明显的增加。在对VX2兔行经皮肝穿刺乙酸化学消融时,化学位移像乙酸弥散范围(最大层面)与大体标本肿瘤的坏死范围(最大层面)存在显著的正相关性,相关有统计学意义。
3、无水乙醇注射的相关部位化学位移像上无水乙醇信号明显增加。VX2肿瘤兔行PEI时,化学位移像无水乙醇弥散范围(最大层面)与大体标本肿瘤的坏死范围(最大层面)存在显著的正相关性,相关有统计学意义。
4、化学位移像,在注射的部位,局部无水乙醇信号明显的增加。在对VX2兔PEI时,化学位移成像使在肿瘤弥散的无水乙醇成像。T2加权像,在治疗后有多种信号改变。病灶信号在化学位移像与T2加权像的信噪比和对比信噪比差异有显著性。无水乙醇分布范围与病理上肿瘤的坏死范围有正相关性,相关有统计学意义。
结论
1、PEI时, T2加权像能初步地用于监控无水乙醇的分布。
2、化学位移成像能够用于监控MR导向化学消融肝肿瘤时乙酸的分布。
3、化学位移成像能够用于监控MR导向肝肿瘤PEI时无水乙醇分布。
4、PEI时,化学位移成像能够比T2加权像更精确地用于监控无水乙醇的分布。
Objective:Liver cancer is very common and a significant cause of mortality and morbidity in china. Although, in many cases, surgical resection or transplantation offers the only chance for cure, most patients with HCC are not candidates for these treatments. Recently, several minimally invasive, nonsurgical local therapies have been described. These include embolization therapy, radiofrequency ablation, laser-induced thermotherapy, and chemical ablation with use of ethanol or acetic acid. When performed for small ( 3 cm) HCC, chemical ablation can achieve 5-year survival rates of 60%, equivalent to those of surgical resection. A recent randomized, controlled trial suggested that acetic acid ablation is more effective than ethanol ablation in patients with HCC smaller than 3 cm. But, the kidney toxicity of Acetic acid has restricted its application. ethanol ablation has been regarded highly by people ,got the universally accepted consistent curative effect.the side effect is more small relatively.Chemical ablation has most commonly been performed with use of either ultrasound or computed tomographic guidance. Unfortunately, these modalities do not allow for direct visualization of the chemical agents being injected. Instead, the volume to be injected is determined based on the morphology and size of the lesion.
Methods:
1 Tumor implantation of a solid vx2 tumor in the liver was carried out in New Zealand white rabbits. These rabbits was placed in a 10-cm birdcage transmit/receive coil on a 1.5-T MR imaging system. Transverse images of these rabbits were then acquired with use of a two-dimensional, SE T1WI,FSPGR T1WI,FRFSE T2WI, Confirm a tumour cultivating success. Puts 2 rabbits to death after scanning, is used for pathological examination. The spare VX2 tumors rabbits were performed with percutaneous chemical ablation.
2 MRI-guided technology FRFSE is use as guarding a means. Carry out the fixing position and the puncture on a 1.5-T MR scanner. Control the direction and depth of puncture needle with MR scanner. demonstrates puncture needle point in lesion and performs PEI.
3 Chemical-shift MR Imaging VX2 tumors were carried out in these rabbits. Chemical-shift MR imaging was performed in Phantom and VX2 tumors of rabbits during PEI with FRFSE T2WI on a 1.5-T MR scanner.Images of the phantom were generated with the spectrometer frequency centered on the acetate resonance determined to be shifted -240Hz (or -170 Hz)from the water resonance. The offset frequency of the chemical shift suppression pulse was set at 240 Hz.
Result:
1 Focal signal increases varies in T2-Weighted imaging after PEI at the site of injection. The study revealed there was significant positive in radiologic-pathologic correlation.
2 Phantom data demonstrated focal increases in the observed signal in chemical-shift MR imaging that correlate well with the site of injection. The study in a hepatic VX2 tumor of rabbits revealed focal signal at the injection site. There is significant positive in the radiologic-pathologic correlation.
3 Focal increases in the observed signal in chemical-shift MR imaging that correlate well with the site of injection. The study in hepatic VX2 tumors of rabbits revealed focal signal at the injection site. There is significant positive in the radiologic-pathologic correlation.
4 Focal signal increases in chemical-shift MR imaging and varies in T2-Weighted imaging after PEI at the site of injection. The study revealed there were significant differences in lesion-to-liver contrast-to-noise ratios on chemical-shift MR imaging and T2-weighted imaging and both positive radiologic-pathologic correlation.
Conclusions:
1 Ethanol distribution may be preliminarily monitored with T2-weight imaging during PEI.
2 Chemical-shift MR imaging may be used to Acetic Acid visualize distribution during percutaneous chemical ablation procedures
3 chemical-shift MR imaging may be used to visualize ethanol distribution during PEI.
4 Ethanol distribution may be more accurately monitored with Chemical-shift MR imaging than with T2-weight imaging during PEI.
方法:
1、肝VX2瘤兔制备.采用包埋法将肿瘤种植在新西兰大白兔肝脏,种植3周后,全麻下行MRI扫描。1.5T超导磁共振扫描仪,头颈联合8通道线圈,常规:SE T1WI,FSPGR T1WI,FRFSE T2WI扫描,证实肿瘤种植成功。2只VX2瘤兔扫描后,处死,用于病理检查。余兔行MRI导向经皮穿刺化学消融注射术。
2、磁共振介入技术:采用快速翻转快速自旋回波序列(FRFSE)作为监视手段,在闭孔式1.5T超导磁共振扫描仪上进行定位穿刺, MRI扫描监控穿刺针方向和深度,当MRI扫描证实穿刺针针尖插入病灶内即可行PEI治疗。
3、化学位移磁共振成像:应用FRFSE T2WI序列同时采用选择性化学选择饱和磁共振组织抑制技术,将波谱频率中心调到以乙酸甲基H质子的共振频率(-170HZ)或无水乙醇甲基H质子的共振频率(大约-240 HZ),同时进行水饱和抑制以压制水共振的信号进行化学位移成像来完成对试验模型及PEI消融VX2肝肿瘤术中的扫描。
结果
1、在对VX2兔PEI时,T2加权像,在治疗后有多种信号改变,利用乙醇治疗前后的信号变化,无水乙醇分布范围与病理上肿瘤的坏死范围有正相关性,相关有统计学意义。
2、50%乙酸注射的相关部位信号明显的增加。在对VX2兔行经皮肝穿刺乙酸化学消融时,化学位移像乙酸弥散范围(最大层面)与大体标本肿瘤的坏死范围(最大层面)存在显著的正相关性,相关有统计学意义。
3、无水乙醇注射的相关部位化学位移像上无水乙醇信号明显增加。VX2肿瘤兔行PEI时,化学位移像无水乙醇弥散范围(最大层面)与大体标本肿瘤的坏死范围(最大层面)存在显著的正相关性,相关有统计学意义。
4、化学位移像,在注射的部位,局部无水乙醇信号明显的增加。在对VX2兔PEI时,化学位移成像使在肿瘤弥散的无水乙醇成像。T2加权像,在治疗后有多种信号改变。病灶信号在化学位移像与T2加权像的信噪比和对比信噪比差异有显著性。无水乙醇分布范围与病理上肿瘤的坏死范围有正相关性,相关有统计学意义。
结论
1、PEI时, T2加权像能初步地用于监控无水乙醇的分布。
2、化学位移成像能够用于监控MR导向化学消融肝肿瘤时乙酸的分布。
3、化学位移成像能够用于监控MR导向肝肿瘤PEI时无水乙醇分布。
4、PEI时,化学位移成像能够比T2加权像更精确地用于监控无水乙醇的分布。
Objective:Liver cancer is very common and a significant cause of mortality and morbidity in china. Although, in many cases, surgical resection or transplantation offers the only chance for cure, most patients with HCC are not candidates for these treatments. Recently, several minimally invasive, nonsurgical local therapies have been described. These include embolization therapy, radiofrequency ablation, laser-induced thermotherapy, and chemical ablation with use of ethanol or acetic acid. When performed for small ( 3 cm) HCC, chemical ablation can achieve 5-year survival rates of 60%, equivalent to those of surgical resection. A recent randomized, controlled trial suggested that acetic acid ablation is more effective than ethanol ablation in patients with HCC smaller than 3 cm. But, the kidney toxicity of Acetic acid has restricted its application. ethanol ablation has been regarded highly by people ,got the universally accepted consistent curative effect.the side effect is more small relatively.Chemical ablation has most commonly been performed with use of either ultrasound or computed tomographic guidance. Unfortunately, these modalities do not allow for direct visualization of the chemical agents being injected. Instead, the volume to be injected is determined based on the morphology and size of the lesion.
Methods:
1 Tumor implantation of a solid vx2 tumor in the liver was carried out in New Zealand white rabbits. These rabbits was placed in a 10-cm birdcage transmit/receive coil on a 1.5-T MR imaging system. Transverse images of these rabbits were then acquired with use of a two-dimensional, SE T1WI,FSPGR T1WI,FRFSE T2WI, Confirm a tumour cultivating success. Puts 2 rabbits to death after scanning, is used for pathological examination. The spare VX2 tumors rabbits were performed with percutaneous chemical ablation.
2 MRI-guided technology FRFSE is use as guarding a means. Carry out the fixing position and the puncture on a 1.5-T MR scanner. Control the direction and depth of puncture needle with MR scanner. demonstrates puncture needle point in lesion and performs PEI.
3 Chemical-shift MR Imaging VX2 tumors were carried out in these rabbits. Chemical-shift MR imaging was performed in Phantom and VX2 tumors of rabbits during PEI with FRFSE T2WI on a 1.5-T MR scanner.Images of the phantom were generated with the spectrometer frequency centered on the acetate resonance determined to be shifted -240Hz (or -170 Hz)from the water resonance. The offset frequency of the chemical shift suppression pulse was set at 240 Hz.
Result:
1 Focal signal increases varies in T2-Weighted imaging after PEI at the site of injection. The study revealed there was significant positive in radiologic-pathologic correlation.
2 Phantom data demonstrated focal increases in the observed signal in chemical-shift MR imaging that correlate well with the site of injection. The study in a hepatic VX2 tumor of rabbits revealed focal signal at the injection site. There is significant positive in the radiologic-pathologic correlation.
3 Focal increases in the observed signal in chemical-shift MR imaging that correlate well with the site of injection. The study in hepatic VX2 tumors of rabbits revealed focal signal at the injection site. There is significant positive in the radiologic-pathologic correlation.
4 Focal signal increases in chemical-shift MR imaging and varies in T2-Weighted imaging after PEI at the site of injection. The study revealed there were significant differences in lesion-to-liver contrast-to-noise ratios on chemical-shift MR imaging and T2-weighted imaging and both positive radiologic-pathologic correlation.
Conclusions:
1 Ethanol distribution may be preliminarily monitored with T2-weight imaging during PEI.
2 Chemical-shift MR imaging may be used to Acetic Acid visualize distribution during percutaneous chemical ablation procedures
3 chemical-shift MR imaging may be used to visualize ethanol distribution during PEI.
4 Ethanol distribution may be more accurately monitored with Chemical-shift MR imaging than with T2-weight imaging during PEI.
引文
1周康荣,颜志平,严福华等.中华影像医学肝胆胰脾卷.人民卫生出版社2002;33。
2 Rgimbeau JM, Farges O, Shen BY,et al.Is surgery for large hepatocellar carcinoma justified? J hepatol. 1999;31:1062-068
3 Dalla Valle R, Borie D, Hannoun L, et al. Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis. 2000; 32: 346–356.
4 Hussain SA,Ferry DR,EI-Gazzaz G,et al. hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
5 Yogita S, Tashiro S. Current status of surgical treatment for hepatocellular carcinoma. J Med Invest. 2000; 47: 91–100.
6 Lin DY, Lin SM, Liaw YF et al. Non-surgical treatment of hepatocellular carcinoma. J Gastroenterol Hepatol.1997; 12: S319–S328.
7 Ikeda M, Okada S, Ueno H, et al.Radiofrequency ablation and percutaneous ethanol injection in patients with small hepatocellular carcinoma: a comparative study. Jpn J Clin Oncol. 2001; 31: 322–326.
8 Livraghi T, Lazzaroni S, Meloni F. Radiofrequency thermal ablation of hepatocellular carcinoma. Eur J Ultrasound 2001; 13: 159–166.
9 Okada S. Local ablation therapy for hepatocellular carcinoma. Semin Liver Dis.1999; 19: 323–328.
10 Usatoff V, Habib NA. Update of laser-induced thermotherapy for liver tumors. Hepatogastroenterology. 2001; 48: 330–332.
11 Livraghi T, Vettori C. Percutaneous ethanol injection therapy of hepatoma. CardiovascIntervent Radiol 1990; 13: 146–152.
12 Ohnishi K, Nomura F, Ito S, et al.Prognosis of small hepatocellular carcinoma (less than 3 cm) after percutaneous acetic acid injection: study of 91 cases. Hepatology.1996; 23: 994–1002.
13 Yamamoto J, Okada S, Shimada K, et al. Treatment strategy for small hepatocellular carcinoma: comparison of long-term results after percutaneous ethanol injection therapy and surgical resection. Hepatology 2001; 34: 707–713.
14 David S .K.Lu, Shantanu Sinha, John Lucas,et al.MR-Guided Percutaneous Ethanol Ablation of Liver Tissue in a .2-T Open MR System :Preliminary Study in Porcine Model. J Magn Reson Imaging.1997 7: 303-308.
1 Rgimbeau JM, Farges O, Shen BY, et al.Is surgery for large hepatocellar carcinoma justified? J hepatol.1999;31:1062-1068.
2 Dalla Valle R, Borie D, Hannoun L, et al.Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis. 2000; 32: 346–356.
3 Hussain SA,Ferry DR,EI-Gazzaz G,et al.hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
4马明平,胡道予,周义成,胡国栋等。兔VX2肝癌模型制作及介入治疗的实验研究。放射学实,2000;15:384-386。
5张雪哲MRI导引介入技术的临床应用。中华放射学杂志,2002;36:258-260。
6李波,陈汉等。超声引导肝脏穿刺瘤内注射无水酒精治疗肝癌。中国实用外科杂志,1996;168: 84-85。
7 Burgener FA , Bolondi L ,Lazzaroni S , et al.Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis : A study on 207 patients Cancer; 1992 : 925-929.
8张峰,田建明,康德强等。不同浓度乙醇消融vx2兔移植性肝肿瘤的实验研究。介入放射学,2005:629-633。
9 Singh NP, Lai H, Khan A. Ethanol induced single strand DNA breaks in rat brain cells. Mutation Res (Genetic Toxicol). 1995 : 191-196.
10 Andreas H, Mahnken MD,Arno Buecker, et al. MR-Guided Radiofrequency Ablation of Hepatic Malignancies at 1.5T. J Magn Reson Imaging. 2004: 342-348.
11刘于宝,胡道予,夏黎明等。介入性磁共振器械的研究。放射学实践,2003:611-613。
12 Wildermuth S, Dumoulin CL, Pammatter T, et al. MR-Guided Percutaneous Angioplasty:Assessment of tracking safety,catheter handling and functionality. Cardiovase Intervent Radiol. 1998;404-410.
13 Buecker A, Adam G, Nenrburg JM, et al. MR-Guided Biopsy Using a T2-Weighted Single-Shot Zoom Imaging Sequence(Local Lood Technique). J Magn Reson Imaging.1998; 8:955-961.
14郭友,胡道予,胡丽丽等。1.5T MR导引肝脏经皮穿刺成像技术的探讨。临床放射学杂志,2004:513-516。
15 David S. K.Lu, MD,Shantanu Sinha ,et al.MR-Guided Percutaneous Ethanol Ablation of Liver Tissue in a .2-T Open MR System :Preliminary Study in Porcine Model. J Magn Reson Imaging.1997 : 303-308.
16 Fujita T , Honjo K, Ito K, et al . Fan-shaped hepatic parenchymal damage after ethanol injection therapy for hepatocellular carcinoma :MRI appearances. Abdomen Imaging. 1999:56-60.
1 Rgimbeau JM, Farges O, Shen BY, et al.Is surgery for large hepatocellar carcinoma justified? J hepatol.1999;31:1062-1068.
2 Dalla Valle R, Borie D, Hannoun L, et al.Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis. 2000; 32: 346–356.
3 Hussain SA,Ferry DR,EI-Gazzaz G,et al. hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
4张雪哲MRI导引介入技术的临床应用。中华放射学杂志,2002:258-260。
5 Ohnishi K, Ohyama N, Ito S, et al.Small hepatocellular carcinoma: treatment with US-guided intratumoral injection of acetic acid. Radiology .1994 : 747–752.
6 Ohnishi K, Nomura F, Ito S, et al. Prognosis of small hepatocellular carcinoma (less than 3 cm) after percutaneous acetic acid injection: study of 91 cases. Hepatology. 1996: 994–1002.
7 Andreas H,Mahnken, Arno Buecker, et al MR-Guided Radiofrequency Ablation of Hepatic Malignancies at 1.5T. J Magn Reson Imaging.2004 19:342-348.
8刘于宝,胡道予,夏黎明等。介入性磁共振器械的研究。放射学实践,2003 :611-613。
9 Wildermuth S,Dumoulin CL,Pammatter T, et al. MR-Guided Percutaneous Angioplasty:Assessment of tracking safety catheter handling and functionality.Cardiovase Intervent Radiol. 1998 ;404-410.
10郭友,胡道予,胡丽丽等。1.5T MR导引肝脏经皮穿刺成像技术的探讨。临床放射学杂志, 2004;513-516.
11 David AR, Marc AR, Timothy WIC, et al. Chemical-shift MR Imaging of Acetic Acid during Percutaneous Chemical Ablation Therapy: Preliminary Work.Journal of Vascular and Interventional Radiology. 2002;13:1055-1059.
1 Rgimbeau JM, Farges O, Shen BY, et al. Is surgery for large hepatocellar carcinoma justified? J hepatol .1999;31:1062-1068.
2 Dalla Valle R, Borie D, Hannoun L, et al .Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis. 2000; 32: 346–356.
3 Hussain SA,Ferry DR,EI-Gazzaz G,et al. hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
4张雪哲MRI导引介入技术的临床应用。中华放射学杂志,2002;258-260。
5李波,陈汉等。超声引导肝脏穿刺瘤内注射无水酒精治疗肝癌。中国实用外科杂志,1996;84-85。
6李麟荪,贺能树等。介入放射学。人民卫生出版社,2001:41。
7张峰,田建明,康德强等。不同浓度乙醇消融vx2兔移植性肝肿瘤的实验研究。介入放射学,2005:629-633。
8胡道予,刘于宝,李震等。磁共振带侧孔介入性穿刺针的实验研究。放射学实践, 2004:583-586。
9 Livraghi T, Giorgio A, Marin G, et al . Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection.Radiology.1995;197:101-106.
10左长京,王敏杰,王培军等。可弯曲穿刺针在CT引导下肝脏肿瘤乙醇消融术中的应用。第二军医大学学报,2002:504-506。
11 David S. K Lu, Shantanu Sinha,et al. MR-Guided Percutaneous Ethanol Ablation of Liver Tissue in a .2-T Open MR System :Preliminary Study in Porcine Model. J Magn Reson Imaging.1997;303-308.
12郭友,胡道予,胡丽丽等。1.5T MR导引肝脏经皮穿刺成像技术的探讨。临床放射学杂志,2004:513-516。
13谢敬霞等。核磁共振新技术研与临床应用。北京医科大学出版社,2001;367。
14 Andreas H, Mahnken, Arno Buecker, et al . MR-Guided Radiofrequency Ablation of Hepatic Malignancies at 1.5T. J Magn Reson Imaging.2004 :342-348.
15刘于宝,胡道予,夏黎明等。介入性磁共振器械的研究。放射学实践,2003:611-613。
16 Wildermuth S, Dumoulin CL, Pammatter T, et al.MR-Guided Percutaneous Angioplasty: Assessment of tracking safety, catheter handling and functionality.Cardiovase Intervent Radiol.1998 ;404-410.
17 Buecker A,Adam G,Nenrburg JM, et al. MR-Guided Biopsy Using a T2-Weighted Single-Shot Zoom Imaging Sequence(Local Lood Technique). J Magn Reson Imaging.1998:955-961.
18郭友,胡道予,胡丽丽等。1.5T MR导引肝脏经皮穿刺成像技术的探讨。临床放射学杂志,2004;513-516。
19 Hiroshi Shinmoto, Robert V, Mulkern, et al. MR Apperance and Spectral Features of Injected Ethanol in the Liver:Implication for fast MR-Guided Percutaneous Ethanol Injection Therapy. Journal of Computer Assisted Tomography.1997: 82-88.
1 Rgimbeau JM, Farges O, Shen BY,I et al.Is surgery for large hepatocellar carcinoma justified? J hepatol 1999;31:1062-1068.
2 Dalla Valle R, Borie D, Hannoun L, et al.Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis.2000; 32: 346–356.
3 Hussain SA,Ferry DR,EI-Gazzaz G,et al. hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
4 Yogita S, Tashiro S. Current status of surgical treatment for hepatocellular carcinoma. J Med Invest. 2000; 47: 91–100.
5谢敬霞,杨正汉等。核磁共振新技术研与临床应用。2001;367。
6 Kim CK,Lim JH,Lee WJ.Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic liver:accuracy of ultrasonograph in transplant patients.J Ultrasound Med. 2001;20:99-104.
7 Shibata T, Iimuro Y, Yamamoto Y, et al. CT-guided Transthoracic Percutaneous Ethanol Injection for Hepatocellular Carcinoma Not Detectable with US .Radiology. 2002; 223: 115-120.
8 Hiroshi Shinmoto, Robert V, Mulkern, et al. MR Apperance and Spectral Features of Injected Ethanol in the Liver:Implication for fast MR-Guided Percutaneous Ethanol Injection Therapy. Journal of Computer Assisted Tomography .1997: 82-88.
9 Fujita T , Honjo K, Ito K, et al . Fan-shaped hepatic parenchymal damage after ethanol injection therapy for hepatocellular carcinoma :MRI appearances. Abdomen Imaging. 1999;56-60.
1. Silverman SG..Interactive MR-guided biopsy in an open-configuration MR imaging system. Radiology. 1995:175-181.
2. Adam G. Interventional magnetic resonance. Initial clinical experience with a 1.5-tesla magnetic resonance system combined with c-arm fluoroscopy. Invest Radiol. 1997;191-197.
3.张雪哲,洪闻,陆立等。MRI导引介入技术的临床应用的探讨。中华放射学杂志, 1998 :600-603。
4.张雪哲MRI导引介入技术的临床应用。中华放射学杂志,2002:258-260.
5.李麟荪,贺能树等。介入放射学。人民卫生出版社,2001:41。
6.林礼务,叶真,薛恩生等。超声介入注射无水酒精治疗肝癌的量化研究。2000;16:514-516。
7. Shibata T, Iimuro Y, Yamamoto Y, et al. CT-guided Transthoracic Percutaneous Ethanol Injection for Hepatocellular Carcinoma Not Detectable with US .Radiology.2002; 223: 115-120.
8. David AR, Marc AR, Timothy WIC, et al. Chemical-shift MR Imaging of Acetic Acid during Percutaneous Chemical Ablation Therapy: Preliminary Work Journal of Vascular and Interventional. Radiology. 2002;13:1055-1059.
9. David S. K Lu, Shantanu Sinha,et al. MR-Guided Percutaneous Ethanol Ablation of Liver Tissue in a .2-T Open MR System :Preliminary Study in Porcine Model. J Magn Reson Imaging.1997;303-308.
10. Kurokohchi K, Masaki T, Miyauchi Y, et al. Percutaneous ethanol and lipiodol injection therapy for hepatocellular carcinoma.Int J Oncol. 2004;24:381-387.
11. Konig CW, Trubenbach J, Fritz J , et al. Contrast enhanced MR-guided biopsy of hepatocellular carcinoma. Abdom Imaging. 2004;29:71-76.
12. Andreas H, Mahnken MD,Arno Buecker, et al. MR-Guided Radiofrequency Ablation of Hepatic Malignancies at 1.5T. J Magn Reson Imaging. 2004; 342-348.
13. Kariniemi J, Blanco Sequeiros R, Ojala R, et al. MRI-guided abdominal biopsy in a0.23-T open-configuration MRI system. Eur Radiol. 2005;15:1256-1262.
14. Kim YJ,Raman SS,Yu NC,Lu DS. MR-guided percutaneous ethanol injection for hepatocellular carcinoma in a 0.2T open MR system. J Magn Reson Imaging. 2005;22:566-588.
15. Robert B.Interventional MRI .Mosby,Inc 1999 ;245
16. Lu DS, Lu DS, Sinha S ,et al. MR-guided percutaneous ethanol ablation of liver tissue in a .2-T open MR system: preliminary study in porcine model. J Magn Reson Imaging.1997; 7:303-308.
17. Nagel HS,Bernardino ME. Contrast-enhanced MR imaging of hepatic lesions treated with percutaneous ethanol ablation therapy. Radiology. 1993;189:265-70.
18. Sironi S. Small hepatocellular carcinoma treated with percutaneous ethanol injection: unenhanced and gadolinium-enhanced MR imaging follow-up.Radiology. 1994;192: 407-412.
19. Bartolozzi C. mri-guided ethanol ablation Treatment of hepatocellular carcinoma with percutaneous ethanol injection: evaluation with contrast-enhanced MR imaging. Am J Roentgenol. 1994;162:827-831.
1张峰,田建明,康德强,等。不同浓度乙醇消融vx2兔移植性肝肿瘤的实验研究[J]。介入放射学,2005:629-633.
2 Jacobs DL,Clark TWI, Soulen MC .Parenchymal diffusion following hepatic injection of acetic acid versus ethanol. J Vas Interv Radiol. 2001;12:S23.
3 Lencioni R, Della Pina C, Crocetti L, et al.Percutaneous ablation of hepatocellular carcinoma.Recent Results Cancer Res. 2006;167:91-105. Review.
4 Huo TI, Huang YH, Wu JC.Percutaneous ablation therapy for hepatocellular carcinoma: current practice and future perspectives.J Chin Med Assoc. 2005; 68: 155-159. Review.
5 Dillehay LE. Decreasing resistance during fast infusion of a subcutaneous tumor. Anticancer Res.1997; 17: 461–466.
6 Dimitrakopoulou-Strauss A, Strauss LG, Gutzler F, et al. Pharmacokinetic imaging of 11C ethanol with PET in eight patients with hepatocellular carcinomas who were scheduled for treatment with percutaneous ethanol injection. Radiology.1999; 211: 681–686.
7 Ho CS, Kachuar JR,Gallinger S,et al. Percutaneous ethanol injection of unresectable medium-to-large-sized hepatomas using a multipronged needle: efficacy and safety.Cardiovasc Intervent Radiol. 2007 ;30:241-247.
8 Blendis L. Percutaneous ethanol ablation of small hepatocellular carcinomas: twenty years on.Gastroenterology. 2006;130:280-282.
9 Ebara M, Okabe S, Kita K, et al. Percutaneous ethanol injection for small hepatocellular carcinoma: therapeutic efficacy based on 20-year observation.J Hepatol. 2005;43:458-464.
10 Lee MJ, Mueller PR, Dawson SL, et al. Percutaneous ethanol injection for the treatment of hepatic tumors: indications, mechanism of action, technique, and efficacy. AJR Am J Roentgenol.1995; 164: 215–220.
11 Shiina S, Tagawa K, Unuma T, et al. Percutaneous ethanol injection therapy for hepatocellular carcinoma: a histopathologic study. Cancer.1991; 68: 1524–1530.
12 Ishii H, Okada S, Nose H, et al. Local recurrence of hepatocellular carcinoma after percutaneous ethanol injection. Cancer.1996; 77: 1792–1796.
13 Livraghi T. Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis.Hepatogastroenterology. 2001;48:20-4.
14 Di Stasi M, Buscarini L, Livraghi T, et al. Percutaneous ethanol injection in the treatment of hepatocellular carcinoma: a multicenter survey of evaluation practices and complication rates. Scand J Gastroenterol.1997; 32: 1168–1173.
15 R. K. Gelczer,J. W. Charboneau,S. Hussain, et al.Complications of percutaneous ethanol ablationJ. Ultrasound Med. 1998; 17: 531.
16 Ohmoto K, Kunieda T, Shibata N, Yamamoto S. Intraperitoneal hemorrhage as a major complication of percutaneous ethanol injection therapy for hepatocellular carcinoma. Hepatogastroenterology. 2000: 1199–1202.
17 Redvanly RD, Chezmar JL, Strauss RM, et al.Malignant hepatic tumors: safety of high-dose percutaneous ethanol ablation therapy. Radiology.1993; 188: 283–285.
18左长京,王敏杰,王培军,等.可弯曲穿刺针在CT引导下肝脏肿瘤乙醇消融术中的应用.第二军医大学学报,2002 ,23 :504-506。
19 Tapani E, Vehmas T, Taavitsainen M. Ultrasound monitoring of experimental ethanol injection into pig liver. Acad Radiol.1994; 1: 21–24.
20 Obi S, Shiratori Y, Shiina S, et al. Early detection of haemobilia associated with percutaneous ethanol injection for hepatocellular carcinoma. Eur J Gastroenterol Hepatol. 2000: 285–290.
21 Livraghi T, Lazzaroni S, Pellicano S, Percutaneous ethanol injection of hepatic tumors: single-session therapy with general anesthesia. AJR Am J Roentgenol.1993; 161: 1065–1069.
22 Iannarone C, Caratozzolo M, Costamagna L, et al. Transcutaneous ethanol injection in hepatocarcinoma: problems in analgesia and sedation. Eur Rev Med Pharmacol Sci. 1997; 1: 217–221.
23 Livraghi T, Benedini V, Lazzaroni S, et al.Long-term results of single-session percutaneous ethanol injection in patients with large hepatocellular carcinoma. Cancer. 1998; 83: 48–57.
24 Giorgio A, Tarantino L, Francica G, et al. One-shot percutaneous ethanol injection of liver tumors under general anesthesia: preliminary data on efficacy and complications. Cardiovasc Intervent Radiol.1996; 19: 27–31.
25 Giorgio A, Tarantino L, Mariniello N, et al. Percutaneous ethanol injection under general anesthesia for hepatocellular carcinoma: 3-year survival in 112 patients. Eur J Ultrasound.1998; 8: 201–206.
26 Giorgio A, Tarantino L, de Stefano G, et al. Ultrasound-guided percutaneous ethanol injection under general anesthesia for the treatment of hepatocellular carcinoma on cirrhosis: long-term results in 268 patients. Ultrasound.2000: 145–154.
27 Lencioni R, Cioni D, Uliana M, et al. Fatal thrombosis of the portal vein following single-session percutaneous ethanol injection therapy of hepatocellular carcinoma. Abdom Imaging.1998; 23: 608–610.
28 Lencioni R, Caramella D, Bartolozzi C. Hepatocellular carcinoma: use of color Doppler US to evaluate response to treatment with percutaneous ethanol injection. Radiology. 995; 194: 113–118.
29 Spiezia S, Vallone P, Fiore F, et al. Power Doppler sonography to evaluate response to percutaneous ethanol injection in hepatocellular carcinoma. Ital J Gastroenterol Hepatol.1997; 29: 548–553.
30 Oito K, Namieno T, Ichimura T, et al. Power Doppler sonography: evaluation of hepatocellular carcinoma after treatment with transarterial embolization or percutaneous ethanol injection therapy. Am J Roentgenol .2000: 337–341.
31 Sato S, Shiratori Y, Imamura M, et al. Power Doppler signals after percutaneous ethanol injection therapy for hepatocellular carcinoma predict local recurrence of tumors: a prospective study using 199 consecutive patients. Hepatol. 2001: 225–234.
32 Bartolozzi C, Lencioni R, Ricci P, Paolicchi A, Rossi P, Passariello R. Hepatocellular carcinoma treatment with percutaneous ethanol injection: evaluation with contrast-enhanced color Doppler US. Radiology.1998; 209: 387–393.
33 Fiore F, Vallone P, Ricchi P, et al. Levovist-enhanced Doppler sonography versus spiral computed tomography to evaluate response to percutaneous ethanol injection in hepatocellular carcinoma. Clin Gastroenterol. 2000: 164–168.
34 Ding H, Kudo M, Onda H, et al. Evaluation of posttreatment response of hepatocellular carcinoma with contrast-enhanced coded phase-inversion harmonic US: comparison with dynamic CT. Radiology. 2001: 721–730.
35 Numata K, Tanaka K, Kiba T, et al. Nonresectable hepatocellular carcinoma: improved percutaneous ethanol injection therapy guided by CO(2)-enhanced sonography. Am J Roentgenol. 2001: 789–798.
36 Bartolozzi C, Lencioni R, Caramella D, et al. Hepatocellular carcinoma: CT and MR features after transcatheter arterial embolization and percutaneous ethanol injection. Radiology.1994; 191: 123–128.
37 Catalano O, Cusati B, Sandomenico F, et al. Helical CT findings in patients with hepatocellular carcinoma treated with percutaneous ablation procedures. Comput Assist Tomogr. 2000;748–754.
38 Catalano O, Lobianco R, Esposito M,et al. Hepatocellular carcinoma recurrence after percutaneous ablation therapy: helical CT patterns.Abdom Imaging. 2001;26:375-83.
39 Kim YJ,Raman SS,Yu NC,et al. MR-guided percutaneous ethanol injection for hepatocellular carcinoma in a 0.2T open MR system. J Magn Reson Imaging. 2005;22:566-588.
40 Nagel HS, Bernardino ME. Contrast-enhanced MR imaging of hepatic lesions treated with percutaneous ethanol ablation therapy. Radiology 1993; 189: 265–270.
41 Lencioni R, Caramella D, Bartolozzi C. Response of hepatocellular carcinoma to percutaneous ethanol injection: CT and MR evaluation. J Comput Assist Tomogr.1993; 17: 723–729.
42 Fujita T, Honjo K, Ito K, et al. Dynamic MR follow-up of small hepatocellular carcinoma after percutaneous ethanol injection therapy. J Comput Assist Tomogr.1998; 22: 379–386.
43 Bartolozzi C, Crocetti L, Cioni D, et al. Assessment of therapeutic effect of liver tumor ablation procedures. Hepatogastroenterology .2001: 352–358.
44 Khan KN, Yatsuhashi H, Yamasaki K, et al. Prospective analysis of risk factors for early intrahepatic recurrence of hepatocellular carcinoma following ethanol injection. J Hepatol. 2000: 269–278.
45 Castellano L, Calandra M, Del Vecchio Blanco C, et al.Predictive factors of survival and intrahepatic recurrence of hepatocellular carcinoma in cirrhosis after percutaneous ethanol injection: analysis of 71 patients. J Hepatol.1997; 27: 862–870.
46 Koda M, Murawaki Y, Mitsuda A, et al. Predictive factors for intrahepatic recurrence after percutaneous ethanol injection therapy for small hepatocellular carcinoma. Cancer. 2000;529–537.
47 Mazzanti R, Arena U, Pantaleo P, Survival and prognostic factors in patients with hepatocellular carcinoma treated by percutaneous ethanol injection: a 10-year experience.Can J Gastroenterol. 2004;18:611-618.
48 Wakai T,Shirai Y,Suda T,et al. Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma < or =4 cm. World J Gastroenterol. 2006;12:546-552.
49 Sung YM, Choi D, Lim HK, et al. Long-term results of percutaneous ethanol injection for the treatment of hepatocellular carcinoma in Korea.Korean J Radiol. 2006;7:187-92
50 Yamamoto J, Okada S, Shimada K, et al. Treatment strategy for small hepatocellular carcinoma: comparison of long-term results after percutaneous ethanol injection therapy and surgical resection. Hepatology .2001: 707–713.
51 Livraghi T, Goldberg SN, Lazzaroni S, et al.Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology.1999; 210: 655–661.
52 Caturelli E. Percutaneous ablative therapies for small hepatocellular carcinoma: radio-frequency or percutaneous ethanol injection? Radiology. 2000; 216: 304–306.
53 Ohnishi K, Ohyama N, Ito S, et al. Small hepatocellular carcinoma: treatment with US-guided intratumoral injection of acetic acid. Radiology. 1994; 193: 747–752.
54 Ohnishi K, Nomura F, Ito S, et al. Prognosis of small hepatocellular carcinoma (less than 3 cm) after percutaneous acetic acid injection: study of 91 cases. Hepatology. 1996; 23: 994–1002.
55 Ohnishi K, Yoshioka H, Ito S, et al. Prospective randomized controlled trial comparing percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma. Hepatology. 1998; 27: 67–72.
56 Ohnishi K. Comparison of percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma. Hepatogastroenterology.1998; 45 (suppl 3): 1254–1258.
57 Van Hoof M, Joris JP, Horsmans Y, Geubel A. Acute renal failure requiring haemodialysis after high-dose percutaneous acetic acid injection for hepatocellular carcinoma. Acta Gastroenterol Belg.1999; 62: 49–51.
58 Boseniuk S, Rieger C. [Acute oral acetic acid poisoning: case report]. Anaesthesiol Reanim.1994; 19: 80–82.
59 Tamai T, Seki T, Imamura M, et al. Percutaneous injection of a low-concentration alkaline solution targeting hepatocellular carcinoma. Oncol Rep. 2000; 719–723.
60 Timmer J, de Kam SS, Sauerwein HP,et al. Use of sodium hydroxide solution to clear partially occluded vascular access ports. J Parenter Enteral Nutr. 1993: 289–291.
61 Tanaka K, Okazaki H, Nakamura S, et al. Hepatocellular carcinoma: treatment with a combination therapy of transcatheter arterial embolization and percutaneous ethanol injection. Radiology .1991; 713–717.
62 Tanaka K, Nakamura S, Numata K, et al. The long-term efficacy of combined transcatheter arterial embolization and percutaneous ethanol injection in the treatment of patients with large hepatocellular carcinoma and cirrhosis. Cancer.1998: 78–85.
63 Dohmen K, Shirahama M, Shigematsu H, et al. Transcatheter arterial chemoembolization therapy combined with percutaneous ethanol injection for unresectable large hepatocellular carcinoma: an evaluation of the local therapeutic effect and survival rate. Hepatogastroenterology.2001: 1409–1415.
64 Bartolozzi C, Lencioni R, Caramella D, et al. Treatment of large HCC: transcatheter arterial chemoembolization combined with percutaneous ethanol injection versus repeated transcatheter arterial chemoembolization. Radiology.1995; 197: 812–818.
65 Koda M, Murawaki Y, Mitsuda A, et al. Combination therapy with transcatheter arterial chemoembolization and percutaneous ethanol injection compared with percutaneous ethanol injection alone for patients with small hepatocellular carcinoma: a randomized control study. Cancer. 2001;1516–1524.
2 Rgimbeau JM, Farges O, Shen BY,et al.Is surgery for large hepatocellar carcinoma justified? J hepatol. 1999;31:1062-068
3 Dalla Valle R, Borie D, Hannoun L, et al. Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis. 2000; 32: 346–356.
4 Hussain SA,Ferry DR,EI-Gazzaz G,et al. hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
5 Yogita S, Tashiro S. Current status of surgical treatment for hepatocellular carcinoma. J Med Invest. 2000; 47: 91–100.
6 Lin DY, Lin SM, Liaw YF et al. Non-surgical treatment of hepatocellular carcinoma. J Gastroenterol Hepatol.1997; 12: S319–S328.
7 Ikeda M, Okada S, Ueno H, et al.Radiofrequency ablation and percutaneous ethanol injection in patients with small hepatocellular carcinoma: a comparative study. Jpn J Clin Oncol. 2001; 31: 322–326.
8 Livraghi T, Lazzaroni S, Meloni F. Radiofrequency thermal ablation of hepatocellular carcinoma. Eur J Ultrasound 2001; 13: 159–166.
9 Okada S. Local ablation therapy for hepatocellular carcinoma. Semin Liver Dis.1999; 19: 323–328.
10 Usatoff V, Habib NA. Update of laser-induced thermotherapy for liver tumors. Hepatogastroenterology. 2001; 48: 330–332.
11 Livraghi T, Vettori C. Percutaneous ethanol injection therapy of hepatoma. CardiovascIntervent Radiol 1990; 13: 146–152.
12 Ohnishi K, Nomura F, Ito S, et al.Prognosis of small hepatocellular carcinoma (less than 3 cm) after percutaneous acetic acid injection: study of 91 cases. Hepatology.1996; 23: 994–1002.
13 Yamamoto J, Okada S, Shimada K, et al. Treatment strategy for small hepatocellular carcinoma: comparison of long-term results after percutaneous ethanol injection therapy and surgical resection. Hepatology 2001; 34: 707–713.
14 David S .K.Lu, Shantanu Sinha, John Lucas,et al.MR-Guided Percutaneous Ethanol Ablation of Liver Tissue in a .2-T Open MR System :Preliminary Study in Porcine Model. J Magn Reson Imaging.1997 7: 303-308.
1 Rgimbeau JM, Farges O, Shen BY, et al.Is surgery for large hepatocellar carcinoma justified? J hepatol.1999;31:1062-1068.
2 Dalla Valle R, Borie D, Hannoun L, et al.Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis. 2000; 32: 346–356.
3 Hussain SA,Ferry DR,EI-Gazzaz G,et al.hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
4马明平,胡道予,周义成,胡国栋等。兔VX2肝癌模型制作及介入治疗的实验研究。放射学实,2000;15:384-386。
5张雪哲MRI导引介入技术的临床应用。中华放射学杂志,2002;36:258-260。
6李波,陈汉等。超声引导肝脏穿刺瘤内注射无水酒精治疗肝癌。中国实用外科杂志,1996;168: 84-85。
7 Burgener FA , Bolondi L ,Lazzaroni S , et al.Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis : A study on 207 patients Cancer; 1992 : 925-929.
8张峰,田建明,康德强等。不同浓度乙醇消融vx2兔移植性肝肿瘤的实验研究。介入放射学,2005:629-633。
9 Singh NP, Lai H, Khan A. Ethanol induced single strand DNA breaks in rat brain cells. Mutation Res (Genetic Toxicol). 1995 : 191-196.
10 Andreas H, Mahnken MD,Arno Buecker, et al. MR-Guided Radiofrequency Ablation of Hepatic Malignancies at 1.5T. J Magn Reson Imaging. 2004: 342-348.
11刘于宝,胡道予,夏黎明等。介入性磁共振器械的研究。放射学实践,2003:611-613。
12 Wildermuth S, Dumoulin CL, Pammatter T, et al. MR-Guided Percutaneous Angioplasty:Assessment of tracking safety,catheter handling and functionality. Cardiovase Intervent Radiol. 1998;404-410.
13 Buecker A, Adam G, Nenrburg JM, et al. MR-Guided Biopsy Using a T2-Weighted Single-Shot Zoom Imaging Sequence(Local Lood Technique). J Magn Reson Imaging.1998; 8:955-961.
14郭友,胡道予,胡丽丽等。1.5T MR导引肝脏经皮穿刺成像技术的探讨。临床放射学杂志,2004:513-516。
15 David S. K.Lu, MD,Shantanu Sinha ,et al.MR-Guided Percutaneous Ethanol Ablation of Liver Tissue in a .2-T Open MR System :Preliminary Study in Porcine Model. J Magn Reson Imaging.1997 : 303-308.
16 Fujita T , Honjo K, Ito K, et al . Fan-shaped hepatic parenchymal damage after ethanol injection therapy for hepatocellular carcinoma :MRI appearances. Abdomen Imaging. 1999:56-60.
1 Rgimbeau JM, Farges O, Shen BY, et al.Is surgery for large hepatocellar carcinoma justified? J hepatol.1999;31:1062-1068.
2 Dalla Valle R, Borie D, Hannoun L, et al.Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis. 2000; 32: 346–356.
3 Hussain SA,Ferry DR,EI-Gazzaz G,et al. hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
4张雪哲MRI导引介入技术的临床应用。中华放射学杂志,2002:258-260。
5 Ohnishi K, Ohyama N, Ito S, et al.Small hepatocellular carcinoma: treatment with US-guided intratumoral injection of acetic acid. Radiology .1994 : 747–752.
6 Ohnishi K, Nomura F, Ito S, et al. Prognosis of small hepatocellular carcinoma (less than 3 cm) after percutaneous acetic acid injection: study of 91 cases. Hepatology. 1996: 994–1002.
7 Andreas H,Mahnken, Arno Buecker, et al MR-Guided Radiofrequency Ablation of Hepatic Malignancies at 1.5T. J Magn Reson Imaging.2004 19:342-348.
8刘于宝,胡道予,夏黎明等。介入性磁共振器械的研究。放射学实践,2003 :611-613。
9 Wildermuth S,Dumoulin CL,Pammatter T, et al. MR-Guided Percutaneous Angioplasty:Assessment of tracking safety catheter handling and functionality.Cardiovase Intervent Radiol. 1998 ;404-410.
10郭友,胡道予,胡丽丽等。1.5T MR导引肝脏经皮穿刺成像技术的探讨。临床放射学杂志, 2004;513-516.
11 David AR, Marc AR, Timothy WIC, et al. Chemical-shift MR Imaging of Acetic Acid during Percutaneous Chemical Ablation Therapy: Preliminary Work.Journal of Vascular and Interventional Radiology. 2002;13:1055-1059.
1 Rgimbeau JM, Farges O, Shen BY, et al. Is surgery for large hepatocellar carcinoma justified? J hepatol .1999;31:1062-1068.
2 Dalla Valle R, Borie D, Hannoun L, et al .Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis. 2000; 32: 346–356.
3 Hussain SA,Ferry DR,EI-Gazzaz G,et al. hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
4张雪哲MRI导引介入技术的临床应用。中华放射学杂志,2002;258-260。
5李波,陈汉等。超声引导肝脏穿刺瘤内注射无水酒精治疗肝癌。中国实用外科杂志,1996;84-85。
6李麟荪,贺能树等。介入放射学。人民卫生出版社,2001:41。
7张峰,田建明,康德强等。不同浓度乙醇消融vx2兔移植性肝肿瘤的实验研究。介入放射学,2005:629-633。
8胡道予,刘于宝,李震等。磁共振带侧孔介入性穿刺针的实验研究。放射学实践, 2004:583-586。
9 Livraghi T, Giorgio A, Marin G, et al . Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection.Radiology.1995;197:101-106.
10左长京,王敏杰,王培军等。可弯曲穿刺针在CT引导下肝脏肿瘤乙醇消融术中的应用。第二军医大学学报,2002:504-506。
11 David S. K Lu, Shantanu Sinha,et al. MR-Guided Percutaneous Ethanol Ablation of Liver Tissue in a .2-T Open MR System :Preliminary Study in Porcine Model. J Magn Reson Imaging.1997;303-308.
12郭友,胡道予,胡丽丽等。1.5T MR导引肝脏经皮穿刺成像技术的探讨。临床放射学杂志,2004:513-516。
13谢敬霞等。核磁共振新技术研与临床应用。北京医科大学出版社,2001;367。
14 Andreas H, Mahnken, Arno Buecker, et al . MR-Guided Radiofrequency Ablation of Hepatic Malignancies at 1.5T. J Magn Reson Imaging.2004 :342-348.
15刘于宝,胡道予,夏黎明等。介入性磁共振器械的研究。放射学实践,2003:611-613。
16 Wildermuth S, Dumoulin CL, Pammatter T, et al.MR-Guided Percutaneous Angioplasty: Assessment of tracking safety, catheter handling and functionality.Cardiovase Intervent Radiol.1998 ;404-410.
17 Buecker A,Adam G,Nenrburg JM, et al. MR-Guided Biopsy Using a T2-Weighted Single-Shot Zoom Imaging Sequence(Local Lood Technique). J Magn Reson Imaging.1998:955-961.
18郭友,胡道予,胡丽丽等。1.5T MR导引肝脏经皮穿刺成像技术的探讨。临床放射学杂志,2004;513-516。
19 Hiroshi Shinmoto, Robert V, Mulkern, et al. MR Apperance and Spectral Features of Injected Ethanol in the Liver:Implication for fast MR-Guided Percutaneous Ethanol Injection Therapy. Journal of Computer Assisted Tomography.1997: 82-88.
1 Rgimbeau JM, Farges O, Shen BY,I et al.Is surgery for large hepatocellar carcinoma justified? J hepatol 1999;31:1062-1068.
2 Dalla Valle R, Borie D, Hannoun L, et al.Surgical treatment of hepatocellular carcinoma in cirrhosis. Dig Liver Dis.2000; 32: 346–356.
3 Hussain SA,Ferry DR,EI-Gazzaz G,et al. hepatocellar carcinoma.Ann Oncol. 2001 ;12:161-172.
4 Yogita S, Tashiro S. Current status of surgical treatment for hepatocellular carcinoma. J Med Invest. 2000; 47: 91–100.
5谢敬霞,杨正汉等。核磁共振新技术研与临床应用。2001;367。
6 Kim CK,Lim JH,Lee WJ.Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic liver:accuracy of ultrasonograph in transplant patients.J Ultrasound Med. 2001;20:99-104.
7 Shibata T, Iimuro Y, Yamamoto Y, et al. CT-guided Transthoracic Percutaneous Ethanol Injection for Hepatocellular Carcinoma Not Detectable with US .Radiology. 2002; 223: 115-120.
8 Hiroshi Shinmoto, Robert V, Mulkern, et al. MR Apperance and Spectral Features of Injected Ethanol in the Liver:Implication for fast MR-Guided Percutaneous Ethanol Injection Therapy. Journal of Computer Assisted Tomography .1997: 82-88.
9 Fujita T , Honjo K, Ito K, et al . Fan-shaped hepatic parenchymal damage after ethanol injection therapy for hepatocellular carcinoma :MRI appearances. Abdomen Imaging. 1999;56-60.
1. Silverman SG..Interactive MR-guided biopsy in an open-configuration MR imaging system. Radiology. 1995:175-181.
2. Adam G. Interventional magnetic resonance. Initial clinical experience with a 1.5-tesla magnetic resonance system combined with c-arm fluoroscopy. Invest Radiol. 1997;191-197.
3.张雪哲,洪闻,陆立等。MRI导引介入技术的临床应用的探讨。中华放射学杂志, 1998 :600-603。
4.张雪哲MRI导引介入技术的临床应用。中华放射学杂志,2002:258-260.
5.李麟荪,贺能树等。介入放射学。人民卫生出版社,2001:41。
6.林礼务,叶真,薛恩生等。超声介入注射无水酒精治疗肝癌的量化研究。2000;16:514-516。
7. Shibata T, Iimuro Y, Yamamoto Y, et al. CT-guided Transthoracic Percutaneous Ethanol Injection for Hepatocellular Carcinoma Not Detectable with US .Radiology.2002; 223: 115-120.
8. David AR, Marc AR, Timothy WIC, et al. Chemical-shift MR Imaging of Acetic Acid during Percutaneous Chemical Ablation Therapy: Preliminary Work Journal of Vascular and Interventional. Radiology. 2002;13:1055-1059.
9. David S. K Lu, Shantanu Sinha,et al. MR-Guided Percutaneous Ethanol Ablation of Liver Tissue in a .2-T Open MR System :Preliminary Study in Porcine Model. J Magn Reson Imaging.1997;303-308.
10. Kurokohchi K, Masaki T, Miyauchi Y, et al. Percutaneous ethanol and lipiodol injection therapy for hepatocellular carcinoma.Int J Oncol. 2004;24:381-387.
11. Konig CW, Trubenbach J, Fritz J , et al. Contrast enhanced MR-guided biopsy of hepatocellular carcinoma. Abdom Imaging. 2004;29:71-76.
12. Andreas H, Mahnken MD,Arno Buecker, et al. MR-Guided Radiofrequency Ablation of Hepatic Malignancies at 1.5T. J Magn Reson Imaging. 2004; 342-348.
13. Kariniemi J, Blanco Sequeiros R, Ojala R, et al. MRI-guided abdominal biopsy in a0.23-T open-configuration MRI system. Eur Radiol. 2005;15:1256-1262.
14. Kim YJ,Raman SS,Yu NC,Lu DS. MR-guided percutaneous ethanol injection for hepatocellular carcinoma in a 0.2T open MR system. J Magn Reson Imaging. 2005;22:566-588.
15. Robert B.Interventional MRI .Mosby,Inc 1999 ;245
16. Lu DS, Lu DS, Sinha S ,et al. MR-guided percutaneous ethanol ablation of liver tissue in a .2-T open MR system: preliminary study in porcine model. J Magn Reson Imaging.1997; 7:303-308.
17. Nagel HS,Bernardino ME. Contrast-enhanced MR imaging of hepatic lesions treated with percutaneous ethanol ablation therapy. Radiology. 1993;189:265-70.
18. Sironi S. Small hepatocellular carcinoma treated with percutaneous ethanol injection: unenhanced and gadolinium-enhanced MR imaging follow-up.Radiology. 1994;192: 407-412.
19. Bartolozzi C. mri-guided ethanol ablation Treatment of hepatocellular carcinoma with percutaneous ethanol injection: evaluation with contrast-enhanced MR imaging. Am J Roentgenol. 1994;162:827-831.
1张峰,田建明,康德强,等。不同浓度乙醇消融vx2兔移植性肝肿瘤的实验研究[J]。介入放射学,2005:629-633.
2 Jacobs DL,Clark TWI, Soulen MC .Parenchymal diffusion following hepatic injection of acetic acid versus ethanol. J Vas Interv Radiol. 2001;12:S23.
3 Lencioni R, Della Pina C, Crocetti L, et al.Percutaneous ablation of hepatocellular carcinoma.Recent Results Cancer Res. 2006;167:91-105. Review.
4 Huo TI, Huang YH, Wu JC.Percutaneous ablation therapy for hepatocellular carcinoma: current practice and future perspectives.J Chin Med Assoc. 2005; 68: 155-159. Review.
5 Dillehay LE. Decreasing resistance during fast infusion of a subcutaneous tumor. Anticancer Res.1997; 17: 461–466.
6 Dimitrakopoulou-Strauss A, Strauss LG, Gutzler F, et al. Pharmacokinetic imaging of 11C ethanol with PET in eight patients with hepatocellular carcinomas who were scheduled for treatment with percutaneous ethanol injection. Radiology.1999; 211: 681–686.
7 Ho CS, Kachuar JR,Gallinger S,et al. Percutaneous ethanol injection of unresectable medium-to-large-sized hepatomas using a multipronged needle: efficacy and safety.Cardiovasc Intervent Radiol. 2007 ;30:241-247.
8 Blendis L. Percutaneous ethanol ablation of small hepatocellular carcinomas: twenty years on.Gastroenterology. 2006;130:280-282.
9 Ebara M, Okabe S, Kita K, et al. Percutaneous ethanol injection for small hepatocellular carcinoma: therapeutic efficacy based on 20-year observation.J Hepatol. 2005;43:458-464.
10 Lee MJ, Mueller PR, Dawson SL, et al. Percutaneous ethanol injection for the treatment of hepatic tumors: indications, mechanism of action, technique, and efficacy. AJR Am J Roentgenol.1995; 164: 215–220.
11 Shiina S, Tagawa K, Unuma T, et al. Percutaneous ethanol injection therapy for hepatocellular carcinoma: a histopathologic study. Cancer.1991; 68: 1524–1530.
12 Ishii H, Okada S, Nose H, et al. Local recurrence of hepatocellular carcinoma after percutaneous ethanol injection. Cancer.1996; 77: 1792–1796.
13 Livraghi T. Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis.Hepatogastroenterology. 2001;48:20-4.
14 Di Stasi M, Buscarini L, Livraghi T, et al. Percutaneous ethanol injection in the treatment of hepatocellular carcinoma: a multicenter survey of evaluation practices and complication rates. Scand J Gastroenterol.1997; 32: 1168–1173.
15 R. K. Gelczer,J. W. Charboneau,S. Hussain, et al.Complications of percutaneous ethanol ablationJ. Ultrasound Med. 1998; 17: 531.
16 Ohmoto K, Kunieda T, Shibata N, Yamamoto S. Intraperitoneal hemorrhage as a major complication of percutaneous ethanol injection therapy for hepatocellular carcinoma. Hepatogastroenterology. 2000: 1199–1202.
17 Redvanly RD, Chezmar JL, Strauss RM, et al.Malignant hepatic tumors: safety of high-dose percutaneous ethanol ablation therapy. Radiology.1993; 188: 283–285.
18左长京,王敏杰,王培军,等.可弯曲穿刺针在CT引导下肝脏肿瘤乙醇消融术中的应用.第二军医大学学报,2002 ,23 :504-506。
19 Tapani E, Vehmas T, Taavitsainen M. Ultrasound monitoring of experimental ethanol injection into pig liver. Acad Radiol.1994; 1: 21–24.
20 Obi S, Shiratori Y, Shiina S, et al. Early detection of haemobilia associated with percutaneous ethanol injection for hepatocellular carcinoma. Eur J Gastroenterol Hepatol. 2000: 285–290.
21 Livraghi T, Lazzaroni S, Pellicano S, Percutaneous ethanol injection of hepatic tumors: single-session therapy with general anesthesia. AJR Am J Roentgenol.1993; 161: 1065–1069.
22 Iannarone C, Caratozzolo M, Costamagna L, et al. Transcutaneous ethanol injection in hepatocarcinoma: problems in analgesia and sedation. Eur Rev Med Pharmacol Sci. 1997; 1: 217–221.
23 Livraghi T, Benedini V, Lazzaroni S, et al.Long-term results of single-session percutaneous ethanol injection in patients with large hepatocellular carcinoma. Cancer. 1998; 83: 48–57.
24 Giorgio A, Tarantino L, Francica G, et al. One-shot percutaneous ethanol injection of liver tumors under general anesthesia: preliminary data on efficacy and complications. Cardiovasc Intervent Radiol.1996; 19: 27–31.
25 Giorgio A, Tarantino L, Mariniello N, et al. Percutaneous ethanol injection under general anesthesia for hepatocellular carcinoma: 3-year survival in 112 patients. Eur J Ultrasound.1998; 8: 201–206.
26 Giorgio A, Tarantino L, de Stefano G, et al. Ultrasound-guided percutaneous ethanol injection under general anesthesia for the treatment of hepatocellular carcinoma on cirrhosis: long-term results in 268 patients. Ultrasound.2000: 145–154.
27 Lencioni R, Cioni D, Uliana M, et al. Fatal thrombosis of the portal vein following single-session percutaneous ethanol injection therapy of hepatocellular carcinoma. Abdom Imaging.1998; 23: 608–610.
28 Lencioni R, Caramella D, Bartolozzi C. Hepatocellular carcinoma: use of color Doppler US to evaluate response to treatment with percutaneous ethanol injection. Radiology. 995; 194: 113–118.
29 Spiezia S, Vallone P, Fiore F, et al. Power Doppler sonography to evaluate response to percutaneous ethanol injection in hepatocellular carcinoma. Ital J Gastroenterol Hepatol.1997; 29: 548–553.
30 Oito K, Namieno T, Ichimura T, et al. Power Doppler sonography: evaluation of hepatocellular carcinoma after treatment with transarterial embolization or percutaneous ethanol injection therapy. Am J Roentgenol .2000: 337–341.
31 Sato S, Shiratori Y, Imamura M, et al. Power Doppler signals after percutaneous ethanol injection therapy for hepatocellular carcinoma predict local recurrence of tumors: a prospective study using 199 consecutive patients. Hepatol. 2001: 225–234.
32 Bartolozzi C, Lencioni R, Ricci P, Paolicchi A, Rossi P, Passariello R. Hepatocellular carcinoma treatment with percutaneous ethanol injection: evaluation with contrast-enhanced color Doppler US. Radiology.1998; 209: 387–393.
33 Fiore F, Vallone P, Ricchi P, et al. Levovist-enhanced Doppler sonography versus spiral computed tomography to evaluate response to percutaneous ethanol injection in hepatocellular carcinoma. Clin Gastroenterol. 2000: 164–168.
34 Ding H, Kudo M, Onda H, et al. Evaluation of posttreatment response of hepatocellular carcinoma with contrast-enhanced coded phase-inversion harmonic US: comparison with dynamic CT. Radiology. 2001: 721–730.
35 Numata K, Tanaka K, Kiba T, et al. Nonresectable hepatocellular carcinoma: improved percutaneous ethanol injection therapy guided by CO(2)-enhanced sonography. Am J Roentgenol. 2001: 789–798.
36 Bartolozzi C, Lencioni R, Caramella D, et al. Hepatocellular carcinoma: CT and MR features after transcatheter arterial embolization and percutaneous ethanol injection. Radiology.1994; 191: 123–128.
37 Catalano O, Cusati B, Sandomenico F, et al. Helical CT findings in patients with hepatocellular carcinoma treated with percutaneous ablation procedures. Comput Assist Tomogr. 2000;748–754.
38 Catalano O, Lobianco R, Esposito M,et al. Hepatocellular carcinoma recurrence after percutaneous ablation therapy: helical CT patterns.Abdom Imaging. 2001;26:375-83.
39 Kim YJ,Raman SS,Yu NC,et al. MR-guided percutaneous ethanol injection for hepatocellular carcinoma in a 0.2T open MR system. J Magn Reson Imaging. 2005;22:566-588.
40 Nagel HS, Bernardino ME. Contrast-enhanced MR imaging of hepatic lesions treated with percutaneous ethanol ablation therapy. Radiology 1993; 189: 265–270.
41 Lencioni R, Caramella D, Bartolozzi C. Response of hepatocellular carcinoma to percutaneous ethanol injection: CT and MR evaluation. J Comput Assist Tomogr.1993; 17: 723–729.
42 Fujita T, Honjo K, Ito K, et al. Dynamic MR follow-up of small hepatocellular carcinoma after percutaneous ethanol injection therapy. J Comput Assist Tomogr.1998; 22: 379–386.
43 Bartolozzi C, Crocetti L, Cioni D, et al. Assessment of therapeutic effect of liver tumor ablation procedures. Hepatogastroenterology .2001: 352–358.
44 Khan KN, Yatsuhashi H, Yamasaki K, et al. Prospective analysis of risk factors for early intrahepatic recurrence of hepatocellular carcinoma following ethanol injection. J Hepatol. 2000: 269–278.
45 Castellano L, Calandra M, Del Vecchio Blanco C, et al.Predictive factors of survival and intrahepatic recurrence of hepatocellular carcinoma in cirrhosis after percutaneous ethanol injection: analysis of 71 patients. J Hepatol.1997; 27: 862–870.
46 Koda M, Murawaki Y, Mitsuda A, et al. Predictive factors for intrahepatic recurrence after percutaneous ethanol injection therapy for small hepatocellular carcinoma. Cancer. 2000;529–537.
47 Mazzanti R, Arena U, Pantaleo P, Survival and prognostic factors in patients with hepatocellular carcinoma treated by percutaneous ethanol injection: a 10-year experience.Can J Gastroenterol. 2004;18:611-618.
48 Wakai T,Shirai Y,Suda T,et al. Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma < or =4 cm. World J Gastroenterol. 2006;12:546-552.
49 Sung YM, Choi D, Lim HK, et al. Long-term results of percutaneous ethanol injection for the treatment of hepatocellular carcinoma in Korea.Korean J Radiol. 2006;7:187-92
50 Yamamoto J, Okada S, Shimada K, et al. Treatment strategy for small hepatocellular carcinoma: comparison of long-term results after percutaneous ethanol injection therapy and surgical resection. Hepatology .2001: 707–713.
51 Livraghi T, Goldberg SN, Lazzaroni S, et al.Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology.1999; 210: 655–661.
52 Caturelli E. Percutaneous ablative therapies for small hepatocellular carcinoma: radio-frequency or percutaneous ethanol injection? Radiology. 2000; 216: 304–306.
53 Ohnishi K, Ohyama N, Ito S, et al. Small hepatocellular carcinoma: treatment with US-guided intratumoral injection of acetic acid. Radiology. 1994; 193: 747–752.
54 Ohnishi K, Nomura F, Ito S, et al. Prognosis of small hepatocellular carcinoma (less than 3 cm) after percutaneous acetic acid injection: study of 91 cases. Hepatology. 1996; 23: 994–1002.
55 Ohnishi K, Yoshioka H, Ito S, et al. Prospective randomized controlled trial comparing percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma. Hepatology. 1998; 27: 67–72.
56 Ohnishi K. Comparison of percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma. Hepatogastroenterology.1998; 45 (suppl 3): 1254–1258.
57 Van Hoof M, Joris JP, Horsmans Y, Geubel A. Acute renal failure requiring haemodialysis after high-dose percutaneous acetic acid injection for hepatocellular carcinoma. Acta Gastroenterol Belg.1999; 62: 49–51.
58 Boseniuk S, Rieger C. [Acute oral acetic acid poisoning: case report]. Anaesthesiol Reanim.1994; 19: 80–82.
59 Tamai T, Seki T, Imamura M, et al. Percutaneous injection of a low-concentration alkaline solution targeting hepatocellular carcinoma. Oncol Rep. 2000; 719–723.
60 Timmer J, de Kam SS, Sauerwein HP,et al. Use of sodium hydroxide solution to clear partially occluded vascular access ports. J Parenter Enteral Nutr. 1993: 289–291.
61 Tanaka K, Okazaki H, Nakamura S, et al. Hepatocellular carcinoma: treatment with a combination therapy of transcatheter arterial embolization and percutaneous ethanol injection. Radiology .1991; 713–717.
62 Tanaka K, Nakamura S, Numata K, et al. The long-term efficacy of combined transcatheter arterial embolization and percutaneous ethanol injection in the treatment of patients with large hepatocellular carcinoma and cirrhosis. Cancer.1998: 78–85.
63 Dohmen K, Shirahama M, Shigematsu H, et al. Transcatheter arterial chemoembolization therapy combined with percutaneous ethanol injection for unresectable large hepatocellular carcinoma: an evaluation of the local therapeutic effect and survival rate. Hepatogastroenterology.2001: 1409–1415.
64 Bartolozzi C, Lencioni R, Caramella D, et al. Treatment of large HCC: transcatheter arterial chemoembolization combined with percutaneous ethanol injection versus repeated transcatheter arterial chemoembolization. Radiology.1995; 197: 812–818.
65 Koda M, Murawaki Y, Mitsuda A, et al. Combination therapy with transcatheter arterial chemoembolization and percutaneous ethanol injection compared with percutaneous ethanol injection alone for patients with small hepatocellular carcinoma: a randomized control study. Cancer. 2001;1516–1524.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |