正常兔肝脏射频消融治疗的MRI与病理学研究  

Findings of radiofrequency ablation in normal rabbit liver:correlation between MRI and histopathology

作　　者：杜端明[1] 邹立秋[2] 郭辉[2] 刘鹏程[2] 佟小强[1] 宋莉[1] 邹英华[1] 

机构地区：[1]北京大学第一医院介入血管外科,北京100034 [2]北京大学深圳医院放射科,广东深圳518036

出　　处：《中国医学影像技术》2007年第6期827-830,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的：评价MRI对正常兔肝射频治疗后的病理变化判断价值。方法：对29只兔肝进行射频消融治疗，分5组，分别于术后即刻、术后1周、2周、4周和8周进行MR检查，并处死，行大体病理和显微病理检查。结果：MRI能清晰反映不同时期消融灶的病理变化情况。消融灶呈凝固性坏死，急性期（O～1周），坏死灶周围可见组织充血或炎性细胞浸润，表现为T1WI等或高信号，T2WI等或低信号，坏死灶周边轻度强化。亚急性期（1～2周），坏死灶周围可见中性粒细胞、淋巴细胞、巨噬细胞浸润及纤维组织增生，表现为T2WI高信号，T1WI低信号，周边环形强化更明显。慢性期（4～8周），外周纤维组织增生明显，表现为T2WI和T1WI均为低信号，周边强化逐渐减轻。结论：MRI能有效反映肝脏消融灶的组织病理变化，准确显示消融灶的范围。Objective To evaluate the correlation between MR imaging and the pathological findings after radiofrequency ablation （RFA） in normal rabbit liver. Methods RFA lesions were created in the livers of 29 rabbits, which were divided into five groups. Animals underwent hepatic RFA were killed after performing MR imaging instantly and at 1, 2, 4 and 8 weeks after the procedure respectively. The correlation between MRI and pathologic findings was performed. Results The RFA lesions appeared necrotic areas, representing early changes in the coagulative necrosis microscopically. In the acute phase （0- 1 weeks）, the congestion and the infiltration of the inflammation cells were seen surrounding the ablation areas. They were hypointense or isointense on T2WI, and hyperintense or isointense on T1WI. Gadolinium-enhanced MR imaging showed a thin enhanced rim surrounding the central coagulative necrosis. In the subacute phase （1 - 2 weeks）, ablated lesions also showed extensive coagulative necrosis and marked infiltration by neutrophils, lymphocytes, macrophages and a peripheral fibrovascular restoration rim microscopically. The later were hyperintense on T2WI, and hypointense on T1WI. Gadolinium-enhanced MR imaging showed the enhancing rim surrounding the central coagulative necrosis. In the chronic phase （4-8 weeks）, a peripheral fibrovascular restoration rim were more obvious. They were hypointense on T1WI and T2WI. Conclusion MR imaging can well correlate the histopathological changes by RFA in the liver.

关 键 词：射频消融 肝脏 兔 病理学 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R-33[医药卫生—诊断学]