MR淋巴管造影显示VX2兔乳腺癌前哨淋巴结  

Magnetic Resonance Lymphography for Sentinel Lymph Node Mapping in VX2 Rabbit Breast Cancer

作　　者：谭红娜[1,2] 彭卫军[1,2] 杨犇龙[3,2] 刘海泉[1,2] 顾雅佳[1,2] 李瑞敏[1,2] 赵广垠[1,2] 沈茜刚[1,2] 

机构地区：[1]复旦大学附属肿瘤医院放射诊断科 [2]复旦大学上海医学院肿瘤学系 [3]复旦大学附属肿瘤医院乳腺外科

出　　处：《中国医学计算机成像杂志》2012年第1期67-71,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨钆剂增强的MR淋巴管造影(MR-LG)用于VX2兔乳腺癌前哨淋巴结(SLN)显像的可行性。方法:采用VX2肿瘤软组织块悬液注射法建立30只兔原位乳腺癌动物模型。实验兔在肿瘤接种前后共行2次MR-LG检查(包括对比剂注射前的STIR序列扫描)。图像3D重建后,淋巴管引流通路上距离原发肿瘤最近的淋巴结定义为SLN,且成像效果根据3D图像上有无淋巴结和淋巴管显像分成良好和较差两个等级;记录STIR序列扫描和MR-LG显示的所有淋巴结,并与前哨淋巴结病理对照。结果:80%(24/30)的荷瘤兔完成第二次MR-LC检查,良好3D图像为79.2%(19/24)。在MR-LG图像上,淋巴结信噪比(SNR)均高于其引流淋巴管和同层肌肉(P值均<0.05),SLN与n-SLN、引流淋巴管与同层肌肉之间的SNR无统计学差异。MR-LG图像上可清晰显示SLN和n-SLN(共26枚)的17只荷瘤兔,其STIR图像上共有28枚淋巴结,且两者淋巴结的大小无明显差异(t=0.124,P=0.902);其SLNB检查获得32枚淋巴结(SLN 18枚,n-SLN 14枚),且淋巴结大小与MR-LG图像上和STIR序列扫描所显示的淋巴结无统计学差异。结论:钆剂增强MR-LG可较好地显像VX2兔乳腺癌SLN。Purpose：To study the feasibility of the interstitial magnetic resonance lymphography （MR- LG） by using Gadolinium contrast agent for sentinel lymph node（SLN） mapping in rabbit VX2 breast cancer. Methods： MR - LG exams were completed on 30 New Zealand White Rabbits before and after VX2 tumor being implanted （including pre - contrast STIR sequence scanning） . SLN was defined as the first lymph node/ s on the lymphatic drainage pathway, and the imaging quality was classified as good grade （with both SLN and lymphatic drainage pathway presented） and poor grade （either SLN or lym- phatic drainage pathway absented） .All lymph nodes were recorded on the images of STIR scanning and MR - LG, and then they were compared with the results of SLN pathology. Results： OOf all bearing tumor rabbits, 80% （24/ 30） were completed the second MR - LG examinations, and the rate of good grade for 3D imaging was 79.2% （19/ 24） . QThe SNR of lymph nodes was higher than that of affected lymph duct and muscle after the contrast agent being injected on MR - LG（both P value ~ 0.05）, but there was no difference between SLN and n- SLN, affected lymph duct and muscle. （~）There were 26 lymphnodes on MR - LG and 28 lymph nodes on STIR scanning in all, but there was no significant difference between the size shown by them（t = 0. 124, P = 0. 902） . （4）All 17 bearing tumor rabbits with good grade imaging underwent the SLN biopsy, and 18 SLN and 14 n- SLN were got. However, the sizes of SLN, which were obtained from SLN biopsy, MR- LG and STIR, were with no differences. Conclusion： The Gadolinium contrast enhanced MR - LG is useful for the SLN mapping in VX2 rabbit breast cancer.

关 键 词：兔VX2肿瘤 乳腺癌 前哨淋巴结 淋巴管造影 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]