摘要
目的探讨兔肝Vx-2瘤化疗栓塞前后磁共振扩散成像（DWI）价值、动态变化特征及病理机制。方法新西兰大白兔40只，采用开腹下块种植方法建立肝VX-2瘤模型，选择40只模型分成4组并于介入术后不同时间行DWI并对各组肿瘤标本行病理检查，对不同时间、不同部位与不同b值组之间的ADC值进行统计分析并与病理对照。结果（1）当b=100s／mm2，非介入组、术后6、16、32、48h组，肿瘤周围ADC值、肿瘤中央ADC值与正常肝ADC值逐渐降低，术后16h达到最低，然后逐渐升高，各部位不同时间ADC值差异均有统计学意义（F=7．325，P〈0．01；F=2．496，P〈0．05；F=6．856，P〈0．01）。（2）介入至术后16h，肿瘤周围部分与正常肝细胞水肿程度迅速增加；术后16、32与48h肿瘤周围正常肝细胞水肿程度逐渐降低，肿瘤周围部分细胞水肿程度先轻微下降后继续增加；肿瘤周围部分坏死较术前有所增加。（3）VX-2瘤坏死部分表现为低信号、高ADC值；成活肿瘤部分表现为高信号、低ADC值。结论化疗栓塞前后DWI能够较好地显示并鉴别肿瘤坏死部分与成活部分；ADC值的变化与术后细胞内水肿、组织坏死及栓塞所引起的微循环障碍的影响等因素相关。
Objective To investigate its dynamic characteristics and pathological mechanism on magnatic resonance diffusion weighted imaging （DWI） after chemoembolization in rabbit liver VX-2 tumor model. Methods Forty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity was opened. Forty VX- 2 tumor models from them were divided into four groups. DWI was performed periodically and respectively for each group after chemoembolization. All VX-2 tumor samples of each group were studied by pathology. The distinction of VX-2 tumors on DWI was assessed by their apparent diffusion coefficient （ADC） values. The statistical significance between different time groups, different area groups, or different b-value groups was calculated using SPSS 12. 0 software. Results When b-value was 100 s/mm2, ADC values in the area of VX-2 tumor periphery, VX-2 tumor central, or normal liver parenchyma around tumor became gradually low in sixteen hours after chemoembolization, and were the lowest at sixteenth hour, and then they increased gradually from sixteenth hour to fourty-eighth hour after chemoembolization. The distinction of ADC between different time groups was significant, respectively （ F = 7. 325, P 〈 0. 01 ; F = 2. 496, P 〈 0. 05 ; F = 6. 856, P 〈 0.01 ）. Cellular edema in the area of VX-2 tumor periphery or normal liver parenchyma around tumor increased quickly in sixteen hours after chemoembolization; however, from sixteenth hour to fortyeighth hour, cellular edema in the area of normal liver parenehyma around tumor decreased gradually and that in the area of VX-2 tumor periphery decreased lightly at first and then increased continually. Cellular necrosis in the area of VX-2 tumor periphery after chemoembolization was more significant than that before chemoembolization. The areas of dead cells in VX-2 tumors manifested low signal and high ADC value while the areas of viable cells manifested high signal and low ADC value. Conclusions DWI is able to detect and discriminate tumor necrotic areas from viable cellular areas before and after chemoembolization. ADC of normal liver parenchyma and VX-2 tumor are influenced by intracellular edema, tissue cellular death, and microcirculation disturbance after chemoembolization.
出处
《中国医师杂志》
CAS
2012年第9期1165-1170,共6页
Journal of Chinese Physician
基金
基金项目：湖南省自然科学基金项目（07JJ4022）、湖南省科技局（2010SK3066）、长沙市科技局（K1005023-31,1104054-21）
关键词
磁共振成像
肝肿瘤
实验性/药物疗法
肝肿瘤
实验性/病理学
化学栓塞
治疗性
兔
Magnetic resonance imaging
Liver neoplasms, experimental/drug therapy
Liver ne- oplasms, experimental/pathology
Chemoembolization, therapeutic
Rabbits
