MR与CT引导下经皮兔VX2肝脏血管旁肿瘤模型制作有效性与安全性的对比研究  

Compared study on the efficacy and safety of MR and CT guided percutaneous VX2 hepatic para-vascular tumor model in rabbits

作　　者：冯旭 冯桂玲 刘彦 孙白瑾涛 李兵[1] 杜勇[1] FENG Xu;FENG Guiling;LIU Yan;SUN Baijintao;LI Bing;DU Yong(Department of Radiology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院放射科,南充637000

出　　处：《磁共振成像》2022年第4期84-88,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：南充市市校合作科研专项(NSMC20170301、19SXHZ0257)。

摘　　要：目的对比研究1.5 T封闭式磁共振(magnetic resonance,MR)与计算机体层摄影(computed tomography,CT)引导下经皮兔VX2肝脏血管旁肿瘤模型制作的有效性及安全性。材料与方法60只新西兰大白兔随机平均分配至MR引导组(n=30)和CT引导组(n=30),分别在MR和CT引导下经皮穿刺至兔肝大血管旁将兔VX2肿瘤组织瘤块种植,评价肿瘤模型制作成功率、穿刺针显影情况、针尖周围血管显影情况、手术时间及安全性。结果MR引导组建模成功率为96.7%,仅1只出现针道转移,CT引导组建模成功率为80.0%,2只出现针道转移,3只肝脏其他部位出现转移灶,1只死亡原因不明,差异有统计学意义(P=0.044)。MR引导组20 G同轴穿刺针在T1加权像(T1 weighted imaging,T1WI)的伪影倍数为(7.26±0.38)倍,CT引导组20 G同轴穿刺针的伪影倍数为(2.51±0.57)倍,差异有统计学意义(P<0.01),但CT引导组13只(43.3%)穿刺针针尖周围出现星芒状低密度伪影,干扰肝内血管显影,差异有统计学意义(χ^(2)=8.523,P<0.01)。MR引导组手术时间明显较CT引导组长(13.32±2.45)min vs.(8.42±1.46)min,P<0.001)。CT引导组2只(6.67%)发生少量腹腔积液。两组均未见肝脓肿、黄疸及膈肌穿孔等严重并发症。结论相比CT引导,MR引导下经皮兔肝脏血管旁肿瘤种植是一种更有效的造模方法,虽然穿刺针伪影倍数大、手术耗时长,但是针尖周围血管显影清晰,并发症发生率低。Objective:To compare the efficacy and safety of 1.5 T closed magnetic resonance(MR)and computed tomography(CT)guided VX2 hepatic para-vascular tumor model in rabbits.Materials and Methods:Sixty New Zealand white rabbits were randomly and equally divided into MR-guided group(n=30)and CT-guided group(n=30).Rabbit VX2 tumor fragments was implanted beside the rabbit hepatic great vessels under MR and CT-guidance in the MR and CT group respective,to evaluate the success rate of tumor model establishment,puncture needle pseudopacity/artifact and vascular development around the needle tip,operation time and safety.Results:The success rate of MR-guided modeling was 96.7%,only 1 rabbit had needle metastasis,the success rate of CT-guided modeling was 80.0%,2 rabbits had needle metastasis,3 rabbits had metastases in other parts of the liver,and 1 had unknown cause of death.The differences in success rate of tumor model establishment between the two groups was statistically significant(P=0.044).The fold number of artifacts at T1 weighted imaging(T1WI)was 7.26±0.38 for the 20 G coaxial puncture needle in the MR-guided group and 2.51±0.57 for the 20 G coaxial puncture needle in the CT-guided group,and the difference was statistically significant(P<0.01),but 13 rabbits(43.3%)in the CT-guided group showed star-shaped hypodense artifacts would appear around the needle tip,which interfered with intrahepatic vascular display,and the difference was statistically significant(χ^(2)=8.523,P<0.01).The operation time was longer in the MR-guided group than in the CT-guided group(13.32±2.45)min in the MR-guided group vs.(8.42±1.46)min in the CT-guided group;P<0.001).A small amount of ascites occurred in 2 patients(6.67%)in the CT-guided group.No serious complications such as liver abscess,jaundice or diaphragmatic perforation were observed in either groups.Conclusions:Compared with CT,MR-guided hepatic para-vascular tumor implantation in rabbits might be a more effective modeling method.Although the needle tip pseudopacity of puncture

关 键 词：磁共振成像 计算机体层摄影 肝脏血管旁肿瘤模型 兔VX2肿瘤 建模成功率 安全性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]