门静脉阻断兔肝VX2移植瘤的CT灌注评价

Hepatic VX2 tumor after portal vein occlusion in rabbits: evaluation with CT perfusion imaging

目的探讨CT灌注成像评价门静脉阻断兔肝VX2移植瘤后血流变化的价值。方法40只新西兰大白兔随机分为门静脉阻断后即刻移植瘤体组(A组)、移植瘤体生长3周后门静脉阻断组(B组)、阴性对照组(C组)、移植瘤体未行门静脉阻断的阳性对照组(D组)各10只。经CT灌注扫描后应用去卷积模式自动计算出肝血流量(BF)、血容量(BV)、平均通过时间(MTT)、血管表面通透性(PS)和肝动脉灌注分数(HAF)等CT灌注参数。结果实验A组BF、BV、MTT和PS值均较对照C组低,BF值:(1.40±0.70)ml/(100 g.min)比(133.21±14.42)ml/(100 g.min)(P<0.01);BV值:(0.33±0.17)ml/100 g比(28.77±3.32)ml/100 g(P<0.01);MTT值:(4.33±1.41)s比(11.67±0.58)s(P<0.01);PS值:(0.15±0.18)ml/(100 g.min)比(22.10±4.39)ml/(100 g.min)(P<0.01)。但实验A组的HAF值较对照C组明显增高:(0.99±0.03)比(0.25±0.06)(P<0.01)。实验B组的BF、BV、MTT和PS值较对照D组降低,而HAF值则明显增高(P<0.01)。结论CT灌注成像可无创直观形象地评价门静脉阻断后兔肝VX2移植瘤的灌注特点。

Objective To study the value of CT perfusion in evaluating blood perfusion of hepatic VX2 tumor after portal vein occlusion in rabbits. Methods Forty New Zealand white rabbits were randomly divided into four groups in 10 each group, including test group A, test group B, negative control group C and positive control group D. To the experimental rabbits in the group A, portal branch ligation （PBL） of the left external branch of portal vein was carried out at the time of implantation of the VX2 tumor tissue into the left external lobe. To the test group B, portal vein PBL of the left external branch was performed after 3 weeks of the tumor implantation of the left external lobe. The weighted summation of the aortic and portal venous curve were de-convolved against the liver parenchymal curve. Functional parameters such as total hepatic blood flow （BF）, hepatic blood volume （BV）, mean transit time （MTT）, permeability of capillary vessel surface （PS） and hepatic arterial fraction （HAF） were calculated, and the change of the hemodynamic was estimated. Results Compared with the control group C, BF （[1.40±0.70] ml/[100 g · min] versus [133.21± 14.42] ml/[100 g·min][P〈0.01]）, BV （[0.33±0.17] ml/100 g versus [28.77±3.32] ml/100 g [P〈0.01]）, MTT （[4.33±1.41]s versus [11.67±0.58] s （P 〈0.01]）, PS （[0.15±0.18] ml/[100 g·min] versus [22. 10±4.39] ml/[100 g ·min][P〈0.01]） of the left external lobe in test group A decreased significantly, and HAF （[0.99 ± 0.03] versus [0.25 ± 0.06] [P〈0.01]） increased significantly. For the edge area of the tumor of the test group B, only HAF increased significantly （P〈0.01）, the other values such as BF, BV, MTT and PS decreased significantly, when compared with those of the control group D （P〈0.01）. Conclusion CT perfusion can directly reflect the characteristics of blood perfusion of hepatic VX2 tumor after portal vein occlusion in rabbits.