USE OF PERFLUOROOCTYLBROMIDE (PFOB) TO DETECT LIVER-ABSCESSES WITH COMPUTED-TOMOGRAPHY - SAFETY AND EFFICACY
USE OF PERFLUOROOCTYLBROMIDE (PFOB) TO DETECT LIVER-ABSCESSES WITH COMPUTED-TOMOGRAPHY - SAFETY AND EFFICACY
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DOI：
10.1097/00004424-199109000-00003
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发表时间：
1991-09-01
影响因子：
6.7
通讯作者：
MITTEN, RM
中科院分区：
文献类型：
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作者：
MATTREY, RF;BROWN, JJ;MITTEN, RM
尽管已知全氟辛基溴(PFOB)可以刺激巨噬细胞，但静脉注射的微粒(IV)可以通过阻断网状内皮系统来抑制身体对感染的反应。由于PFOB增强了CT上的脓肿，作者通过评估PFOB或乳酸林格氏(1，R)对104只兔肝内脓肿的死亡率和脓肿体积，并与76%泛影葡胺(MSD76)的疗效进行比较，评价了其安全性和有效性。脓肿是通过将一种毒性很强的大肠杆菌注射到肝脏中而产生的。两天后，五只兔子死了。其余50只兔静脉注射PFOB 5g/kg，49只静脉注射等体积的1，R。所有兔在注射后4天和10天进行CT扫描。他们在第二次CT扫描前就被杀了。28只兔在处死前30秒静脉注射2ml/kg MSD76静脉注射，CT扫描后冰冻、切片、照相。通过将解剖切片照片和CT图像数字化来计算脓肿体积。MSD76对肝脏的强化作用比液化后的脓肿中心多105个Hounsfield单位(HU)。脓肿壁的强化程度与肝脏相同，导致6个脓肿中有3个显示不到3 mm大小，30%的真实脓肿体积被低估。PFOB对肝脏的增强作用也大于对脓肿中心的增强，但更重要的是，它显著增强了脓肿壁，与肝脏和脓肿中心相比，第4天分别增加了96和148HU，第10天分别增加了141和186HU。因为PFOB增强了脓肿壁和远离脓肿中心的炎症区域，所以它可以检测到所有7个小于3 mm的脓肿，当追踪脓肿壁的内缘和外缘时，导致20%的真实脓肿体积被低估和高估。PFOB组脓肿体积(2.2+/-0.4mL)与MSD76组(2.1+/-0.4mL)差异无统计学意义。可能与治疗相关的非技术性死亡相似(2例在输液前死亡，2例在PFOB后死亡，1例在MSD76后死亡)。PFOB在肝脓肿成像中比常规造影剂更有效。
Although perfluorooctylbromide (PFOB) is known to stimulate macrophages, particulates given intravenously (IV) can inhibit the body's response to infection by blocking the reticuloendothelial system. Since PFOB enhances abscesses on computed tomography (CT), the authors evaluated its safety and efficacy by assessing the mortality and abscess volume in 104 rabbits with intrahepatic abscesses given either PFOB or lactated Ringer's (1,R), and by comparing its efficacy to that of 76% meglumine sodium diatrizoate (MSD76). Abscesses were produced by injecting a virulent strain of E. coli into the liver. Two days later, five of the rabbits had died. Of the remaining rabbits, 50 were given 5 g/kg PFOB IV, and 49 were given an equal volume of 1,R. All rabbits had a CT scan at four and at ten days after infusion. They were killed before the second CT scan. Thirty seconds before being killed, 28 rabbits given LR were given a bolus of 2 ml/kg MSD76 IV. Following CT, rabbits were frozen, sliced, and photographed. Abscess volumes were calculated by digitizing the photographs of the anatomic sections and the CT images. MSD76 enhanced the liver by 105 Hounsfield units (HU) more than the liquefied abscess center. The abscess wall enhanced to the same degree as liver, resulting in nonvisualization of three of six abscesses less than 3 mm in size, and a 30% underestimation of true abscess volume. PFOB also enhanced the liver more than the abscess center, but more importantly, it markedly enhanced the abscess wall, which differed from liver and the abscess center by 96 and 148 HU, respectively, at four days, and 141 and 186 HU, respectively, at ten days after infusion. Because PFOB enhanced the abscess wall and areas of inflammation distant from the abscess center, it allowed the detection of all seven abscesses less than 3 mm in size, and resulted in 20% under- and overestimation of true abscess volume when the inner and outer margins of the abscess wall were traced, respectively. There was no difference in abscess volume between the PFOB group (2.2 +/- 0.4 mL) and the MSD76 group (2.1 +/- 0.4 mL). Nontechnical deaths that could be related to treatment were similar (2 died before infusion, 2 after PFOB, and 1 after MSD76). PFOB is more efficacious than conventional contrast media in hepatic abscess imaging.