剪切波弹性成像评价VX2肝癌模型兔TACE后瘤周纤维化  

Shear wave elastic imaging for evaluating peritumoral fibrosis after TACE in rabbit models of VX2 liver cancer

作　　者：何慧洲 程芝梅 张帅 王黎洲 李苒 许敏 周石 HE Huizhou;CHENG Zhimei;ZHANG Shuai;WANG Lizhou;LI Ran;XU Min;ZHOU Shi(Institute of Imaging,Guizhou Medical University,Guiyang 550000,China;Department of Interventional Radiology,the Affiliated Hospital of Guizhou Medical University,Branch of National Clinical Research Center for Interventional Medicine,Guiyang 550000,China)

机构地区：[1]贵州医科大学影像学院,贵州贵阳550000 [2]贵州医科大学附属医院介入放射科国家放射与治疗临床研究中心分中心,贵州贵阳550000

出　　处：《中国介入影像与治疗学》2022年第8期502-507,共6页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家自然科学基金(81860320、81960328)。

摘　　要：目的以超声剪切波弹性成像(SWE)分析兔VX2肝癌移植瘤模型TACE后肿瘤周围肝组织(以下简称瘤周)纤维化状态。方法选取12只新西兰兔,于超声引导下经皮穿刺肝左叶实质,植入VX2肝癌组织,建立兔VX2肝癌移植瘤模型。将模型兔随机分入TACE组和Sham组,每组6只。对TACE组于建模后2~3周经股动脉插管行肝固有动脉造影,之后对TACE组注入碘化油乳剂,对Sham组注入生理盐水。于术前及术后2周以常规超声观察肿瘤大小,以SWE检测肿瘤、瘤周及肝右叶组织硬度。术后2周检测血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肌酐(Cr)及血尿素氮(BUN)水平。处死动物取肿瘤及瘤周组织,观察肝细胞形态、评估纤维化程度;以Western blot法检测瘤周组织胶原Ⅰ和胶原Ⅲ蛋白表达水平。采用Spearman相关性分析评价瘤周纤维化程度与组织硬度的相关性。结果对12只兔均成功建模,经股动脉插管行肝动脉造影成功率100%(12/12)。2组术前肿瘤体积、肝组织硬度及血清学指标差异均无统计学意义(P均>0.05)。术后2周,相比Sham组,TACE组肿瘤体积缩小,肿瘤及瘤周组织硬度增加,血清ALT、AST升高(P均<0.05)。病理检查显示,TACE组瘤周肝细胞水肿明显,Sham组偶见肝细胞水肿,TACE组瘤周纤维化程度高于Sham组(P<0.01);TACE组瘤周胶原Ⅰ和胶原Ⅲ蛋白表达水平高于Sham组(P均<0.01)。Spearman相关性分析结果表明,瘤周纤维化程度与肝脏硬度呈正相关(r=0.67,P=0.02)。结论TACE后VX2肝癌模型兔瘤周纤维化程度加重;SWE可用于评估肝纤维化程度。Objective To analyze fibrosis of liver tissue around rabbit VX2 liver cancer transplanted tumor model after TACE with ultrasonic shear wave elastic imaging(SWE). Methods Twelve New Zealand rabbits were selected. Block of VX2 tumor tissue were implanted into the left liver parenchyma through percutaneous puncture under ultrasound guidance to establish rabbit models of liver cancer. The models were randomly divided into TACE group and sham group(each n=6). Two to three weeks after modeling, DSA of the proper hepatic artery was performed via catheter intubation of the separated right femoral artery, then iodized oil emulsion and normal saline was injected in TACE group and sham group, respectively. Conventional ultrasound was used to observe tumor size before and 2 weeks after operation, while SWE was used to measure tissue stiffness of tumor, peritumoral and right lobe liver. The serum levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), creatinine(Cr) and blood urea nitrogen(BUN) were detected 2 weeks after operation. Then the rabbits were sacrificed, and the tumors and peritumoral livers were harvested, the hepatocyte morphology was observed, the degree of peritumoral fibrosis was assessed, and the expression levels of collagen Ⅰ and collagen Ⅲ of peritumoral tissue were evaluated. Spearman correlation analysis was used to explore the correlation between the degree of fibrosis and stiffness. Results VX2 liver cancer models were successfully established in all 12 rabbits, and the rate of hepatic arteriography through the right femoral artery was 100%(12/12). There was no significant difference of tumor volume, stiffness nor serological indexes between groups before operation(all P>0.05). Compared with sham group, 2 weeks after operation, in TACE group, the tumor volume was smaller, while the tumor and peritumoral tissue stiffness values, as well as ALT and AST were all higher(all P<0.05). Peritumoral hepatocyte edema was obvious in TACE group, but was occasionally observed in sham group. T

关 键 词：肝肿瘤 化学栓塞 治疗性 弹性成像技术 兔 

分 类 号：R-332[医药卫生] R445.1