Андрология и генитальная хирургия. 2015; 16: 74-82
Применение ультразвукового контрастирования для оценки эффективности суперселективной эмболизации артерий простаты при ее доброкачественной гиперплазии
https://doi.org/10.17650/2070-9781-2015-1-74-82Аннотация
В статье представлен первый российский и международный опыт применения ультразвукового контрастирования для оценки эффективности суперселективной эмболизации артерий простаты при ее доброкачественной гиперплазии. Тщательно описана методика проведения эмболизации артерий простаты при ее гиперплазии. Дан четкий алгоритм и необходимый инструментарий при этом виде операций. Представлено обоснование применения микросфер Embozene (эмбозинов), как наиболее инновационного эмболизационного материала. Данные микросферы обладают памятью формы, которая позволяет им сжиматься до 35 % и немедленно восстанавливать свой первоначальный объем после выхода из микрокатетера. Исследования показали, что микросферы Embozene сохраняют именно свой первоначальный объем и не фрагментируются, что является очень важным фактом для целевой и радикальной эмболизации артерий простаты. Представлены обоснование применения и механические свойства ультразвукового контраста, который избирательно находится только внутри просвета сосудов и позволяет исключить ранний рецидив аденомы простаты после эмболизации ее артерий. Данная область применения ультразвукового контраста позволит исследователям определять характер кровоснабжения простаты и его изменения после эмболизации артерий простаты. Приведены клинические и урофлоуметрические характеристики больных, перенесших эмболизацию. Обозначен вектор применения данной технологии в ликвидации продолженного роста и местного локального рецидива рака простаты.
Список литературы
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Andrology and Genital Surgery. 2015; 16: 74-82
The use of ultrasound contrast to evaluation the effectiveness of superselective embolization of arteries prostate of benign hyperplasia
https://doi.org/10.17650/2070-9781-2015-1-74-82Abstract
The article presents the first Russian and international experience in the application of ultrasound contrast to evaluation the effectiveness of superselective embolization of arteries prostate benign hyperplasia her. Thoroughly describes the methodology of the arteries embolization prostate hyperplasia her. Given a clear algorithm and the necessary tools in this type of operations. Presented rationale for the use of microspheres Embozene as the most innovative embolization material. These microspheres exhibit shape memory, which allows them to shrink to 35 % and immediately recover its original volume after the release of the microcatheter. Studies have shown that the microspheres Embozene retain its original volume is not fragmented, which is a very important fact for the target artery embolization and radical prostate. Attentive readership presents the rationale and mechanical properties of ultrasound contrast, which is only selectively within the lumen of blood vessels and eliminates early relapse of prostate adenoma after embolization her arteries in its application. This area will allow the use of ultrasound contrast followed by researchers to determine the nature of the blood supply to the prostate and its changes after embolization of the arteries of the prostate. The article presents the clinical and uroflowmetry results of patients who underwent embolization. Denotes the vector of this technology in the elimination of the continued growth of the local and local recurrence of prostate cancer.
References
1. Grosso M., Balderi A., Arnò M. et al. Prostatic artery embolization in benign prostatic hyperplasia: preliminary results in 13 patients. Radiol Med 2014. DOI: 10.1007/ s11547-014-0447-3.
2. Carnevale F.C., da Motta-Leal-Filho J.M., Antunes A.A. et al. Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. J Vasc Interv Radiol 2013;24(4):535–42.
3. Bagla S., Martin C.P., van Breda A. et al. Early results from a United States trial of prostatic artery embolization in the treatment of benign prostatic hyperplasia. J Vasc Interv Radiol 2014;25(1):47–52.
4. Moreira A.M., Marques C.F., Antunes A.A. et al. Transient ischemic rectitis as a potential complication after prostatic artery embolization: case report and review of the literature. Cardiovasc Intervent Radiol 2013;36(6):1690–4.
5. Carnevale F.C., Antunes A.A. Prostatic artery embolization for enlarged prostates due to benign prostatic hyperplasia. How I do it. Cardiovasc Intervent Radiol 2013;36(6):1452–63.
6. Martins Pisco J., Pereira J., Rio Tinto H. et al. How to perform prostatic arterial embolization. Tech Vasc Interv Radiol 2012;15(4):286–9.
7. Bilhim T., Tinto H.R., Fernandes L., Martins Pisco J. Radiological anatomy of prostatic arteries. Tech Vasc Interv Radiol 2012;15(4):276–85.
8. Antunes A.A., Carnevale F.C., da Motta Leal Filho J.M. et al. Clinical, laboratorial, and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia. A prospective single-center pilot study. Cardiovasc Intervent Radiol 2013;36(4): 978–86.
9. Pisco J.M., Rio Tinto H., Campos Pinheiro L. et al. Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of shortand mid-term follow-up. Eur Radiol 2013;23(9):2561–72.
10. Rio Tinto H., Martins Pisco J., Bilhim T. et al. Prostatic artery embolization in the treatment of benign prostatic hyperplasia: short and medium follow-up. Tech Vasc Interv Radiol 2012;15(4):290–3.
11. Pereira J., Bilhim T., Duarte M. et al. Patient selection and counseling before prostatic arterial embolization. J Magn Reson Imaging 2013;38(2):380–7.
12. Bilhim T., Pisco J., Rio Tinto H. et al. Unilateral versus bilateral prostatic arterial embolization for lower urinary tract symptoms in patients with prostate enlargement. Cardiovasc Intervent Radiol 2013;36(2):403–11.
13. Carnevale F.C., Antunes A.A., da Motta Leal Filho J.M. et al. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc Intervent Radiol 2010;33(2):355–61.
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18. Sidhu P.S., Allan P.L., Cattin F. et al. Diagnostic efficacy of SonoVue, a second generation contrast agent, in the assessment of extracranial carotid or peripheral arteries using colour and spectral Doppler ultrasound: a multicentre study. Br J Radiol 2006;79(937):44–51.
19. Nedelmann M., Stolz E., Gerriets T. et al. Consensus recommendations for transcranial color-coded duplex sonography for the assessment of intracranial arteries in clinical trials on acute stroke. Stroke 2009;40(10):3238–44.
20. Clevert D.A., Horng A., Reiser M.F. Ultrasound imaging of the abdominal aorta. Radiologe 2009;49(11):1024–32.
21. Strobel D., Seitz K., Blank W. et al. Tumor-specific vascularization pattern of liver metastasis, hepatocellular carcinoma, hemangioma and focal nodular hyperplasia in the differential diagnosis of 1,349 liver lesions in contrast-enhanced ultrasound (CEUS). Ultraschall Med 2009;30(4): 376–82.
22. Catalano O., Aiani L., Barozzi L. et al. CEUS in abdominal trauma: multi-center study. Abdom Imaging 2009;34(2):225–34.
23. Clevert D.A., Weckbach S., Minaifar N. et al. Contrastenhanced ultrasound versus MS-CT in blunt abdominal trauma. Clin Memorheol Microcirc 2008;39(1–4): 155–69.
24. Thorelius L. Emergency real-time contrast-enhanced ultrasonography for detection of solid organ injuries. Eur Radiol 2007;17 Suppl 6:F107–11.
25. Ricci P., Can tisani V., Ballesio L. et al. Benign and malignant breast lesions: efficacy of real time contrast-enhanced ultrasound vs. magnetic resonance imaging. Ultraschall Med 2007;28(1):57–62.
26. Du J., Li F.M., Fang M. et al. Correlation of real-time gray scale contrast-enhanced ultrasonography with microvessel density and vascular endothelial growth factor expression for assessment of angiogenesis in breast lesions. J Ultrasound Med 2008;27(6):821–31.
27. Aigner F., Pallwein L., Mitterberger M. et al. Contrast-enhanced ultrasonography using cadence-contrast pulse sequencing technology for targeted biopsy of the prostate. BJU Int 2009;103(4): 458–63.
28. Tang J., Yang J.C., Li Y. et al. Peripheral zone hypoechoic lesions of the prostate: evaluation with contrast-enhanced gray scale transrectal ultrasonography. J Ultrasound Med 2007;26(12):1671–9.
29. Lamuraglia M., Escudier B., Chami L. et al. To predict progression-free survival and overall survival in metastatic renal cancer treated with sorafenib: pilot study using dynamic contrast-enhanced Doppler ultrasound. Eur J Cancer 2006;42(15):2472–9.
30. Fischer T., Muhler M., Kroncke T.J. et al. Early postoperative ultrasound of kidney transplants: evaluation of contrast medium dynamics using time-intensity curves. Rofo 2004;176(4):472–7.
