多体素1H-MRS对经导管肝动脉化疗栓塞联合内皮抑制素治疗兔VX2肝移植瘤的动态随访研究  

Influence of combination of transcatheter arterial chemoembolization and endostatin on VX2 carcinoma implanted in rabbit liver：dynamic follow-up study by multi-voxel 1H-MRS

作　　者：李海庆[1] 孙业全[1] 张新炎[1] 焦自梅[1] 王锡臻[1] 王滨[2] 

机构地区：[1]潍坊医学院医学影像学系潍坊医学院附属医院影像中心,山东潍坊261053 [2]潍坊医学院医学影像学系,潍坊医学院附属医院影像中心,山东,潍坊,261053 滨州医学院

出　　处：《实用放射学杂志》2011年第12期1919-1924,1940,共7页Journal of Practical Radiology

基　　金：潍坊医学院研究生创新基金立项项目（YC2008041）;山东省教育厅重点项目（J04E01）;山东省科技发展计划项目（2007GG30002032）;山东省卫生系统杰出学科带头人基金（2006-39）.

摘　　要：目的 探讨多体素质子波谱（1H-MRS）在兔VX2肝移植瘤经导管肝动脉化疗栓塞（TACE）联合内皮抑制素（endostatin,ES）治疗过程中的动态随访应用价值.方法 建立兔VX2肝癌模型24只,二维超声监测肿瘤生长情况.待肿瘤长至约1 cm3大小,随机分为3组（每组8只）：对照组（A组）经耳缘静脉给予生理盐水10 ml,连用9 d;TACE＋ES组（B组）经肝动脉给予超液化碘油0.2 ml/kg和阿霉素2 mg/kg,并经耳缘静脉给予内皮抑制素0.7 mg·kg-1·d-1,连续应用9 d;ES组（C组）经耳缘静脉给予内皮抑制素0.7 mg·kg-1·d-1,连用9 d.干预处理前1天及处理后3,6,9 d行T1WI、T2WI及多体素1H-MRS检查.对Cho、Lip、Cr、Glyu、Glx的峰下面积及其与Lip峰下面积比值等指标行统计分析.结果 （1）3组肿瘤组织中各指标均有各自的动态变化趋势（P〈0.01）;（2）治疗后9 d,B组Glyu峰下面积及各代谢物峰下面积比值均小于C组（P〈0.000 1）;A组各代谢物峰下面积大于B、C组（P〈0.000 1）,而峰下面积比值小于B、C组（P〈0.000 1）.（3）干预处理后较前：①A组Cho、Lip、Cr、Glyu峰下面积升高（P〈0.000 1）,Cho/Lip、Cr/Lip、Glyu/Lip比值降低（P〈0.014）;②B组Cho、Cr、Glyu峰下面积降低（P〈0.033）,Cho/Lip、Cr/Lip、Glyu/Lip、Glx/Lip比值降低（P〈0.002）;③C组Cho峰下面积降低（P〈0.000 1）,Lip、Cr、Glyu、Glx峰下面积升高（P〈0.048）,Cho/Lip比值降低（P=0.015）,Glx/Lip比值升高（P=0.027）.结论 多体素1H-MRS可检测到兔VX2肝移植瘤TACE联合内皮抑制素治疗过程中主要代谢物的动态变化,从而可用于动态随访研究,还可对肿瘤治疗疗效及不同治疗方法的疗效进行比较.Objective To explore the value of multi voxel ^1H-MRS in the evaluation of the effect of combination of transcatbeter arterial chemoembolization （TACE） and endostatin （ES） on VX2 carcinoma implanted in rabbit liver. Methods Twenty-four VX2 liver tumor models were established and randomly divided into three groups. Planar sonography was applied to detect the growth of the tumor. When the tumor volume was 1 cm^3 , the following preplanned interference was started： normal saline （10ml/d, 9d） was administered via marginal ear vein of the rabbits in the control group （Group A, n=8） ; lipiodol （0.2 ml/kg） and adramyein （ADM,2 mg/kg） were administered via hepatic artery, as well as ES （0.7 mg· kg^-1· d^-1,gd） via marginal ear vein in Group B （n =8）; ES（0.7 mg· kg^-1· d^-1, 9d） was administered via mar ginal ear vein in groupC （n=8）. TIWl, T：Wland multivoxel 1H MRS were performed one day before the interference and 3, 6, 9 days after the interference. The imaging characteristics and the dynamic changes of the metabolic index of the tumors detected by multiple-voxel 1 H-MRS at different time points were observed and analyzed. Results （1） The dynamic changes of main metabolite of the tumor in each group were of statistical difference. {2） The differences in therapeutic effect of the three kinds of therapy showed that：@ the area under the Glyu peak, as well as the metab- olite-related ratio in group B were less than that in group C; （2） The area under the main metabolite in group B and group C was less than that in group A, while the metabolite-related ratio in group A and B was larger than that of the control group（P〈0. 0001 ）. （3） The main metabolite after the treatment for nine days was compared with that before the treatment and the results were as follow- ing：@ the areas under the Cho, Lip, Cr and Glyu peak were increased （P%0. 0001）, while the rates of Cho/Lip, Cr/Lip, and Glyu/Lip were decreased in the control group（P%0. 014）. （2） In

关 键 词：兔 肝移植瘤 化学栓塞 重组人血管内皮抑制素 磁共振波谱 

分 类 号：R-332[医药卫生] R735.7