氩氦刀治疗兔VX2肝肿瘤的影像表现与病理分析  

Radiologic-histopathologic Findings after Cryoablation of VX2 Hepatic Tumors in Rabbit Models

作　　者：宋春慧 赵伟 李嫚[2] 刘元水[2] 赵文华[2] 郑晓寰[2] 魏有国[2] 

机构地区：[1]枣庄矿业集团中心医院,山东枣庄277000 [2]山东省千佛山医院,山东济南250014

出　　处：《医疗装备》2017年第9期1-3,共3页Medical Equipment

基　　金：山东省自然科学基金资助项目(2007ZRB14001)

摘　　要：目的观察兔VX2肝肿瘤模型氩氦刀冷冻治疗后的影像学表现,与同期病理标本对照以识别残余或复发的肿瘤组织,并比较各种影像学检查的诊断价值。方法建立兔VX2肝肿瘤模型组与正常兔对照组,均行肝脏氩氦刀冷冻治疗,分别在治疗前1天、治疗后1周、2周、3周、4周行CT(平扫和增强)、MRI(平扫和增强)、超声(二维和超声造影)检查,并取同期标本病理作对照。结果 3种影像学检查增强扫描动脉期均显示消融区外缘一环形强化带,约在第4周时消失,病理证实1周时该处组织以充血出血改变及肉芽组织为主,2~4周纤维组织逐渐增多。消融区内完全坏死的组织随时间变化由凝固性坏死逐渐转化为液化性坏死,动态增强扫描无增强。在诊断消融区肿瘤残余及复发方面,增强CT、增强MRI、超声造影诊断正确率均高于CT平扫、MRI平扫、二维超声,增强CT、增强MRI、超声造影诊断正确率相同。结论增强CT、MRI及超声造影更易辨别肿瘤组织与充血出血带,可作为评价肝脏肿瘤冷冻疗效的重要依据。Objective To detect the radiologic-histopathologic correlation of computed tomogropy, magnetic resonance and ultrasonography after cryoablation of VX2 hepatic tumors in the rabitt tumor. In order to find the evidence of residual or recurrent tumors and to evaluate the role of these imaging tests. Methods Hepatic cryoablation was performed in rabbits with VX2 tumors and healthy rabbit. Nonenhanced and dynamic contrast-enhanced computed tomography, magnefic resonance and ultrasonography were performed before cryoablation and during the first week, the second week, the third week, the fourth week after cryoablation. Imaging findings were analyzed compared with histopathologic findings. Results All cryolesions exhibited arterial phase rim enhancement at contrast-enhanced ultrasonography, tomography and magnetic resonance. The rim enhancement disappeared at about the fourth week after cryoablation. Histopathology showed it is mostly granulation tissue and hyperaemia at the first week. Fibrous tissue appeared since the second week while appearance of a large number of fibrous tissue taking the place of granulation tissue during 3-4 weeks, Necrotic tissue did not enhance. Histopathology of the cryolesions showed mainly coagulation necrosis at the early stage and liquefaction necrosis later. On detecting the residual or recurrent tumors, dynamic contrast-enhanced computed tomography, magnetic resonance and ultrasonography were better than nonenhanced computed tomography, magnetic resonance and ultrasonography. Conclusion Contrast-enhanced scanning was easier to distinguish tumor tissues from inflammatory reaction and palying an important role in assessing therapeutic efficiency.

关 键 词：动物 肝肿瘤 冷冻消融 体层摄影术 X线 磁共振成像 超声 

分 类 号：R735.7[医药卫生—肿瘤]