扩散加权成像对肝动脉灌注3-溴丙酮酸治疗大鼠肝癌早期疗效的评价  

Efficacy of ADC in assessing early response to transarterial 3-bromopyruvate therapy of hepatoma in rats

作　　者：易长虹[1] 钱坤[1] 刘园[1] 熊斌[1] 郑传胜[1] 韩萍[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《影像诊断与介入放射学》2013年第5期344-348,共5页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金项目(编号:81371661)

摘　　要：目的探讨扩散加权成像(DWI)对3-溴丙酮酸介入治疗大鼠肝癌模型早期疗效的评价。方法 20只雄性Wistar大鼠采用瘤块种植法建立肝癌模型,种植术后10 d随机分为动脉灌注3-溴丙酮酸组(A组)和生理盐水组(B组),介入术前1 d和术后第3天行MRI检测肿瘤体积和表观扩散系数(ADC),术后第3天处死大鼠,病理分析肿瘤坏死率。结果 14只大鼠完成介入手术(A=10,B=4)。介入术后第3天A、B组肿瘤平均体积为:482.98±103.88 mm^3和255.04±148.30 mm^3,A、B组肿瘤体积无统计学差异(P=0.465);介入术后第3天A、B组肿瘤平均ADC值为(15.15±5.20)×10^(-4)s/mm^2和(7.57±0.53)×10^(-4)s/mm^2,A、B组ADC值有统计学差异(P=0.024)。肿瘤坏死率:A组7例为Ⅲ级坏死,2例为Ⅳ级坏死和1例Ⅰ级坏死,B组4例均为Ⅰ级坏死,治疗后A组肿瘤平均坏死率明显高于B组(P=0.005);肿瘤病理分级与术后ADC值呈正相关(r=0.897)。结论 3-溴丙酮酸对大鼠肝癌模型有较强的抗肿瘤作用,MRI测量肿瘤治疗后早期体积变化不能反映其疗效,尽管ADC值可评估3-溴丙酮酸对大鼠肝癌介入治疗的早期疗效,但尚须进一步研究确立其诊断标准。Objective To investigate the efficacy of diffusion-weighted MR imaging in assessing early response of hepatoma to 3-bromopyruvate in Wistar rats. Methods 20 male Wistar rats were implanted with liver cancer and randomized to a group treated with arterial infusion of 3-bromopyruvate or a control group treated with saline. The tumor volume and apparent diffusion coefficient （ADC） were measured on MRI one day before and 2 days after treatment. All of the rats were then sacrificed and the proportion of tumor necrosis was calculated on histopathologic examination. Results The mean tumor volume after completed treatment of 3-bromopyruvate in 10 rats （482.98 ± 103.88 mm^3） was not significantly （P = 0.465） different from that of 4 rats in the control group （255.04 ± 148.30 mm^3）. On the third day after 3-bromopyruvate treatment, the tumor ADC values （15.15 ± 5.20 × 10^-4 s/mm^2） were significantly （P = 0.024） higher than those of the control group （7.57 ± 0.53 × 10^-4 s/mm^2）. The tumor necrosis was grade Ⅲ （7）, grade IV （2）, and grade Ⅰ （1） after 3-bromopyruvate therapy. The mean tumor necrosis rate was significantly （P = 0.005） higher than that of 4 rats in the control group with grade I necrosis. There was positive correlation between the tumor necrosis grades and ADC values （r = 0.897）. Conclusions Transarterial delivery of 3-bromopyruvate has promising anti-tumor effect, which is reflected by the early elevation of tumor ADC values in rat hepatoma model.

关 键 词：肝细胞癌 经肝动脉化疗 3-溴丙酮酸 动物模型 扩散加权成像 

分 类 号：R735.7[医药卫生—肿瘤]