微泡诱导超声空化联合血凝酶对兔VX2肝癌微血管阻断作用的实验研究  

Experimental Study:Effects and Mechanisms of Microbubble-enhanced Ultrasound Combined with Prothrombin on Blocking the Microvessels in Rabbit VX2 Liver Tumors

作　　者：石颖[1] 谷芬 杨倩 贺建国 周晓东 Shi Ying;Gu Fen;Yang Qian;He Jianguo;Zhou Xiaodong(Department of Ultrasound,the Second Hospital of Shanxi Medtical University,Taiyuan,Shanxi 030001,China;Department of Ultrasound,Xijing Hospital,Fourth Military Medical University,Xi'an,Shanxi 710032,China)

机构地区：[1]山西医科大学第二医院超声诊断科,太原市030001 [2]空军军医大学(原第四军医大学)西京医院超声诊断科

出　　处：《中国超声医学杂志》2019年第1期73-76,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金面上项目(No.81371567)

摘　　要：目的探讨微泡诱导超声空化联合血凝酶对兔VX2肝癌微血管损毁及阻断的作用。方法 32只VX2荷瘤兔随机分为4组:生理盐水组、血凝酶组、空化组和联合组,每组均为8只。4组均经相应的空化假辐照或空化治疗,于实验前后分别行超声造影检查,使用定量图像分析软件分析实验前后CEUS的峰值灰阶值(Peak)变化,通过光镜(HE)观察及透射电镜超微结构显示比较4组的治疗效果。结果实验前后,生理盐水组和血凝酶组超声造影图像视觉分析及定量分析Peak值比较均无明显变化(P>0.05)。空化组和联合组视觉观察可见造影灌注缺损,联合组缺损更为明显。HE染色显示:空化组内偶见局灶片状出血;联合组可见大片状出血及明显的细胞水肿。透射电镜显示:空化组和联合组的微血管壁破坏,基底膜不完整。结论微泡诱导超声空化联合血凝酶能促进内皮损伤并导致更广泛的血栓形成,同时验证了血凝酶可选择性针对肿瘤组织局部损伤的血管,引起快速血栓形成及血流阻塞,并有增强热消融的作用。Objective To investigate the effects and mechanisms of microbubble-enhanced ultrasound combined with prothrombin on blocking and damaging regional circulation in rabbit VX2 liver tumors.Methods 32 animals with VX2 tumors were randomly divided into four groups.They were 8 with the physiological saline group,8 with the prothrombin group,8 treated with cavitation group and 8 with combined group.Corresponding treatment were used in 4 groups:Contrast-enhanced ultrasound was performed on the exposed liver tumors before and after treatment,and acoustic quantification was done and Peak value was obtained to assess the perfusion of liver tumors.Then,the liver tumors were harvested and examined under light microscopy with HE stain and transmission electron microscopy to compare the effects of treatment among all groups.Results CEUS images and peak values of the physiological saline group and the prothrombin group showed no statistical significance(P>0.05).Both of cavitation group and combined group showed defects in the contrast filtration,but it was more obvious in combined group.Piecemeal hemorrhage and intercellular edema were occasionally found in cavitation group under light microscopy.Obvious cellular edema and hematoma were observed in combined group.Transmission electron microscopy showed that microvascular walls were disrupted and the basement membranes were incomplete in cavitation group and combined group.Conclusions Microbubble-enhanced ultrasound combined with prothrombin promotes the endothelial damage and produces larger thrombotic area in liver tumor.It is also verified that prothrombin can selectively cause the injured microvascular of liver tumor to form thrombus and block blood flow quickly,and it enhanced thermal ablation effects.

关 键 词：超声空化 微波热消融 血凝酶 兔VX2肝癌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]