影像学对经皮穿刺兔脊柱VX2肿瘤模型的检测价值探讨  

Value of imaging follow-ups in rabbit spinal metastasis model created by transplantation of VX2 carcinoma under computed tomographic guidance

作　　者：凌龙[1] 何仕诚[1] 黄昊[1] 朱海东[1] 张成佳[1] 方文[1] 郭金和[1] 邓钢[1] 朱光宇[1] 秦永林[1] 滕皋军[1] 

机构地区：[1]东南大学附属中大医院放射科,南京210009

出　　处：《中华医学杂志》2013年第39期3131-3134,共4页National Medical Journal of China

基　　金：国家自然科学基金（81171434）

摘　　要：目的探讨经皮穿刺植入VX2瘤块建立兔脊柱肿瘤模型的MRI和cT表现及其与后肢瘫痪时间之间的关系。方法52只新西兰大白兔随机分为A、B、C、D4组，其中A、B、C3组各14只于CT导向下穿刺腰1或2椎体植入VX2瘤块，D组10只作假手术对照。观察终点：A组，瘫痪后自然死亡或术后第50天；B组，出现瘫痪后第3天；C组，术后第14天；对照组，术后自然死亡或第50天。术后间隔7d定期行脊椎MR及CT，并每天观察后肢神经功能，达到预定观察终点时取出手术椎行病理学检查。结果52只兔椎体穿刺均成功。建立兔脊柱肿瘤模型共32只，对照组存活9只。术后第7天，脊椎成瘤兔32只及对照组9只MRI显示目标椎体内均有异常信号，而CT无阳性发现，术后14d直至研究终点对照组9只兔MRI及CT显示目标椎体正常。术后14dMR和CT的肿瘤显示率分别为65．6％（21／32）和3．1％（1／32），21d分别为100％（21／21）和42．9％（9／21），两个随访点的MRI和CT肿瘤显示率比较差异均有统计学意义（P〈0．01）。术后28d及其后MRI和CT的肿瘤显示率均为100％，差异无统计学意义。A组平均生存时间（40±4）d，D组均存活至术后50d而无后肢瘫痪，两组比较差异有统计学意义（P〈0．01）。A组出现瘫痪时间为术后（22±5）d，B组为术后（22±5）d，两组比较差异无统计学意义（P=0．952）。结论CT导向下穿刺植入VX2瘤块建立兔脊柱肿瘤模型的成瘤率高，可重复性强；MR较CT能更早地显示脊椎肿瘤，但脊椎接种后7d行MRI及CT检查无实际意义；脊椎肿瘤导致后肢瘫痪后可显著缩短模型兔的生存时间。Objective To explore the changes of magnetic resonance imaging （MRI） and computed tomography （CT） after transplantation of VX2 carcinoma into lumbar vertebrae of rabbits under CT guidance and examine its relationship with the onset of paralysis. Methods A total of 52 rabbits were randomly divided into 4 groups. Under CT guidance, pieces of VX2 carcinoma were transplanted into the first or second lumbar vertebra in Groups A, B and C （n = 14 each） while sham operation was performed in Group D （n = 10）. The anticipated endpoints of group A was natural death or Day 50 post-operation, group B Day 3 after onset of paralysis, group C Day 14 post-transplantation and group D natural death or Day 50 post- operation. CT and MR scans were performed at an interval of 7 days and hind limb functions monitored daily post-operation until endpoints. Pathohistological examinations of vertebras were performed at endpoints.Results All lumbar vertebras were successfully transplanted under CT guidance. Thirty-two rabbits with spinal tumor and 9 surviving rabbits in the control group were monitored until endpoints. Abnormal signals on target vertebras appeared on MRI in all 41 rabbits at Day 7 post-operation while positive CT findings were absent. No abnormal MRI/CT findings were found in 9 control rabbits from Day 14 post-operation to the end of study. Significant differences （P 〈 0. 001 ） existed between the rates of tumor visualization with 65.6% （21/32） on MR and 3.1% （1/32） on CT at Day 14, 100% （21/21） on MR and42.9% （9/21） on CT at Day 21. The rates of tumor visualization were 100% on both MR and CT from Day 28 to endpoints. The average survival time of Group A was significantly shorter than Group D （40 ± 4 vs 50 days, P 〈 0. 01 ）. Theonset time of paralysis time in Group A （ 22 ± 5 days） had no significant difference with Group B （ 22 ±5 days） （P = 0. 952）. Conclusion A rabbit model of spinal metastasis is established with high rates of success and reproducibility. Verte

关 键 词：模型 动物 肿瘤转移 脊柱 

分 类 号：R738[医药卫生—肿瘤]