3.0TMR经导管动脉内灌注成像评价不同栓塞方法治疗兔VX2肝肿瘤的栓塞效果  

Evaluation of the embolization effect of different embolization methods on rabbit VX2 liver tumors using 3.0T MR transcatheter arterial perfusion imaging

作　　者：吴安乐 滕飞 林佳 咸玉涛 韩瑞 WU Anle;TENG Fei;LIN Jia;XIAN Yutao;HAN Rui(The First Affiliated Hospital of Ningbo University,Ningbo 315010,Zhejiang,China)

机构地区：[1]宁波大学附属第一医院,宁波315010

出　　处：《现代实用医学》2023年第8期996-1000,共5页Modern Practical Medicine

基　　金：宁波市科技计划项目(2009A610165)。

摘　　要：目的通过4D-经导管动脉内灌注成像(4D-TRIP)测定肿瘤灌注值,旨在术中定量评价经动脉化疗栓塞序贯载药微球栓塞治疗肝肿瘤的栓塞效果。方法建立兔VX2移植瘤模型30只,3周后兔VX2肝肿瘤模型随机分成A、B、C组3组各10只,A组为碘油栓塞组(C-TACE组),B组为载药微球组(D-TACE组),C组为碘油栓塞序贯载药微球栓塞组(S-TACE组)。先行肝肿瘤微导管超选择性肿瘤供血动脉插管,栓塞治疗前(Day0)行3.0T MRI常规序列和4D-TRIP扫描,扫描完成后根据分组行经导管栓塞治疗,治疗后即刻(Day1)再次行3.0T MRI常规序列和4D-TRIP扫描。测定栓塞Day0、Day1肿瘤灌注值Fp,栓塞术后14 d处死全部实验兔,取肝肿瘤组织行HE染色。结果所有实验兔均完成超选择性肿瘤供血动脉插管,Day0时4D-TRIP提示肿瘤动脉期活性部分显著强化,中间囊变坏死区无强化;Day1时肿瘤强化明显减弱,或无明显活性强化。3组栓塞前后灌注值Fp差异均有统计学意义(均P<0.05),3组栓塞术后即刻灌注值Fp差异有统计学意义(P<0.05)。术后14 d病理所见:A组肿瘤内可见成活肿瘤组织;B组肿瘤内可见散在分布血管巢,其内可见残留微球影,并可见灶性残存肿瘤细胞;C组内可见绝大多数肿瘤接近完全坏死,活性肿瘤细胞位于周边组织。结论4D-TRIP成像技术能在体状态下反映肿瘤栓塞前后肿瘤血供情况,较客观反映序贯栓塞术较常规碘油栓塞和载药微球栓塞具有更好的栓塞效果。Objective To quantitatively evaluate the embolization effect of sequential drug loaded microsphere embolization in the treatment of liver tumors during surgery with tumor perfusion value measured by 4D Transcatheter Intraarterial Perfusion Imaging(4D-TRIP).Methods Thirty rabbit VX2 transplanted tumor models were established.After three weeks,the rabbit VX2 liver tumor model was randomly divided into three groups:A,B,and C,with ten mice in each group.Group A was treated with lipiodol embolization(C-TACE group),Group B was treated with drug loaded microspheres(D-TACE group),and Group C was treated with lipiodol embolization sequential drug loaded microspheres embolization(S-TACE group).First,liver tumor microcatheter superselective tumor supply artery catheterization was performed.Before embolization treatment(DayO),3.0T MRI routine sequence and 4D-TRIP scanning were performed.After scanning,transcatheter embolization treatment was performed according to the grouping.Immediately after treatment(Day 1),3.0T MRI routine sequence and 4D-TRIP scanning were performed again.Tumor perfusion value F was measured during embolization on Day0 and Day1.All experimental rabbits were killed 14 days after embolization,and liver tumor tissues were taken for HE staining.Results All experimental rabbits completed superselective tumor supply artery catheterization.At Dayo,4D-TRIP showed significant enhancement of tumor arterial phase activity,with no enhancement in the middle cystic necrotic area.On Day l,tumor enhancement significantly weakened or showed no significant activity enhancement.The differences of three sets of perfusion values Fp before and afer embolization were statistically significant(all P<0.05),and the immediate perfusion value after embolization in the three groups were statistically different(all P<0.05).On the 14th day after surgery,pathological findings showed that viable tumor tissue was visible in the tumor of Group A.Scattered vascular nests can be seen within the tumor of Group B,with re-sidual microsphere

关 键 词：VX2肝肿瘤 经导管动脉灌注成像 载药微球 序贯栓塞 

分 类 号：R816.5[医药卫生—放射医学]