Effect of injection speed on the spread of ethanol during experimental liver ethanol injections

Abstract

Percutaneous ethanol injection therapy may cause serious complications, most likely due to the uncontrolled spread of ethanol. The authors changed the speed of the injection into postmortem pig livers and examined the adverse spread of ethanol from the injection site and the shape and size of the resulting lesion. One milliliter of 96% ethanol was injected into pig livers under sonographic guidance at different speeds (0.075-0.91 mL/s). The spread (graded from I to III) and the volumes and shapes of the resulting lesions seen after dissection were recorded and correlated with the injection speed. When increasing the speed of the injections the large, grade III spread increased significantly (P < .01). The lesions created by more rapid injection were less spherical than were those created by slower injections (P = .08). The volumes of the lesions were not affected by the injection speed. This experimental model suggests that in percutaneous ethanol injection therapy, rapid injection (> 0.3-0.4 mL/s) should be avoided to reduce the uncontrolled spread of ethanol. Spherical spreading of ethanol around the needle tip is best achieved with slow injection.