兔VX2肝癌三维适形放疗后CT表现与病理对照研究  

Comparative Study between CT Features and Pathology of Hepatic VX2 Carcinoma in Rabbits after Three--dimensional Conformal Radiotherapy

作　　者：刘英[1] 孙爱民[1] 袁亚维[1] 李启生[1] 陈龙华[1] 官键[1] 

机构地区：[1]南方医科大学附属南方医院放疗科,广东广州510515

出　　处：《实用放射学杂志》2009年第7期1049-1053,共5页Journal of Practical Radiology

基　　金：广东省自然科学基金资助项目（编号：013056）.

摘　　要：目的探讨CT对观察兔VX2肝癌三维适形放疗后肿瘤及照射区肝组织改变的价值。方法15只新西兰大白兔VX2肝癌模型随机分为低剂量组、高剂量组和对照组，分别给予单次剂量10Gy、30Gy及不采取任何处理。放疗后复查CT与肿瘤、肝组织病理学对比观察。结果对照组的肿瘤平均直径较低剂量组和高剂量组增长迅速[CT测值分别为（62．47±17．14）mm、（16．35±2．05）mm、（14．56±2．13）mm；病理测值为（63．70±16．24）mm、（16．25±2．21）mm，（14．62±1．25）mm]，高剂量组和低剂量组差异无统计学意义（P〉0．05），但与对照组相比，明显小于对照组（P〈0．05）。放疗后CT平扫肿瘤密度减低，高剂量组1只，低剂量组3只荷瘤兔的肿瘤动脉期轻度或明显强化。病理检查见肿瘤组织变性、水肿、出血。高剂量组4只，低剂量组2只增强扫描后肿瘤无强化，病理检查见肿瘤细胞广泛的凝固性坏死。低剂量组80％（4／5）照射区肝组织出现Ⅱ～Ⅲ级肝损伤表现，高剂量组100％（5／5）出现Ⅳ级肝损伤。放疗后高剂量组3只，低剂量组1只CT平扫时肿瘤周围出现同照射区分布一致的低密度带，静脉期轻度强化，病理检查确定为局限性放射性肝损伤区域。结论CT扫描可以反映兔VX2肝癌三维适形放疗后肿瘤坏死、水肿、充血等病理特征及发现照射区肝组织的局限性放射性肝损伤。Objective To suty CT value in evaluating the changes of hepatic VX2 carcinoma in rabbits after three--dimensional conformal radiation therapy（3--DCRT）. Methods Fifteen rabbits with implanted VX2 carcinoma were randomly divided into 3 groups：control group,low dose group （single--dose radiation 10Gy） and high dose group（single--dose radiation 30Gy）. CT was performed 4 weeks after radiotherapy and that results were compared with that of pathological examination. Results The mean diameter of tumors was significantly larger in control group than that in low dose and high dose groups （62.47 ± 17.14） mm , （16.35 ± 2.05 ） mm and （14.56±2.13） mm respectively measured by CT scan,（63.70±16.24） mm,（16.25±2.21） mm and （14.62±1.25） mm respectively measured on pathology examination,there was significant difference between control group and radiotherapeutic groups （P〈0.05） ,but no significant difference between low dose group and high dose group （P〉0.05）. All tumors showed lower density on noncontrast CT in comparison with that of before. The tumors enhanced in 1 case of high dose group and 3 cases of low dose group post contrast--enhanced CT scans. Histopathologically, cegeneration, edema, hemorrhage and congestion were seen in tumors tissues. Widey spread necrosis in the tumors was observed in 1 case of low dose group and 4 cases in high dose group,and the CT imaging showed no enhancement. Eighty percent（4/5） in low dose group showed grade Ⅱ-Ⅲ hepatic injury and 100 percent（5/5） in high dose group showed grade Ⅳ hepatic damage. Three cases in high dose group and 1 case in low dose group appeared limited hypodensity areas in consisitency with the irradiated volume around the tumors on plain CT scans and which were slightly enhanced in venous phase,and histopathology showed that were irradiation--induced hepatic injuries. Conclusion CT images can reflect the necrosis, oedema, congestation pathological charac-- teristic of the postirradiated VX2 tumors and reve

关 键 词：VX2肝癌 三维适形放射治疗 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R-332[医药卫生—临床医学]