Treatment of cerebral lipiodol embolism with fat emulsion injection: an experimental study

Objective: To evaluate the value of removing intracranial lipiodol by fat emulsion injection. Methods: Twelve rabbits were randomly divided into two groups,control group(n = 6) and experimental group(n = 6). All rabbits were injected lipiodol via the internal carotid artery(0.06 ml/kg). When lipiodol was found intracranially by CT scan, the model was considered to be successful. The rabbits were then injected with fat emulsions intravenously immediately following the CT and at intervals of 24 hours, for a total of 6 times(20 ml/kg). Subsequently, the experimental group of rabbits underwent head CT scan at that time and 144 hours later. The control group without treatment underwent head CT scan at the same time interval. The highest density of 0.01 cm² was selected as region of interest and the CT value was measured. Comparison between the two groups at different times used repeated measurements of ANOVA. Same time points between the two groups were compared using the two independent-sample test. Changes of clinical symptoms were observed in rabbits. Results: At 24, 48, 72, 96, 120 hours, 144 hours post-treatment, the CT values of the ROI in the control group and the experimental group were (103.8 ± 7.1), (91.0 ± 4.2), (79.5 ± 5.5), (67.8 ± 6.6), (53.9 ± 5.1), (39.9 ± 3.1)HU respectively and (90.7 ± 5.4), (74.1 ± 4.6), (62.9 ± 4.5),(48.1 ± 3.1),(39.1 ± 1.3), (38.8 ± 1.2)HU respectively. The results of the repeated measurements of ANOVA showed that the CT values difference of the two groups at different time was statistically significant(F = 201.30, P < 0.01). The results of the two independent-samples t test showed that the CT values difference of 24 to 120 hours posttreatment of the two groups also was statistically significant(t = 3.60, 6.64, 5.72, 6.62, 6.89, P < 0.05). After the intra-arterial injection of lipiodol,all animals had different degrees of stroke symptoms.Clinical symptoms disappeared earlier in the experimental group than the control group by 24 hours. Conclusion: Fat emulsions can accelerate the intracranial lipiodolclearence. This study provides some theoretical basis for clinical treatment of cerebrallipiodol embolism. (authors)