犬肝纤维化64排螺旋CT全肝灌注成像及与病理对照、VEGF表达的相关研究

The evaluation of 64-slice spiral CT perfusion to hepatic fibrosis of dog model and the correlation research with pathologic and VEGF change

目的 利用64排螺旋CT全肝灌注模式成像测定中华田园犬肝纤维化模型的相关灌注参数并与病理对照来反映肝纤维化程度,分析其与VEGF表达水平的相关性.方法 采用腹腔注射50％四氯化碳油溶液辅以高脂饮食,建立犬肝纤维化模型,定期行64排螺旋CT全肝灌注成像及肝穿活检.根据病理分期分析各组CT灌注参数,并与VEGF表达水平作对照研究.结果 成功获得各期肝纤维化模型.对照组HAP（28.25 ±2.19） ml/（min·100 g）,PVP（ 53.53±10.71） ml/（ min ·100 g）,TLP（81.78±18.56） ml/（min·100 g）；随肝纤维化程度加重,PVP、TLP持续性下降（P＜0.05）,HAP总体略呈上升趋势.PVP值、TLP值与肝纤维化程度呈负相关（P＜0.01）；VEGF表达水平随着肝纤维化程度的加重而明显增高（P＜0.05）.结论 腹腔注射四氯化碳油溶液辅以高脂饮食可以成功模拟人类从肝细胞变性、肝纤维化至肝硬化的全过程.64排螺旋CT全肝灌注成像克服了以往灌注成像的不足,且能反映肝纤维化各期的血流动力学变化趋势,VEGF可能在慢性肝病所致肝纤维化过程中起重要作用.

Objective To measure the perfusion parameters of liver fibrosis of dog model with 64-slice spiral CT,and compare with positive control to reflect the degree of liver fibrosis,and analyze the correlation with VEGF values.Methods Liver fibrosis was induced in dogs by intraperitoneal injection of CC14 and high fat diet.CT perfusion scan and liver biopsies were performed.The perfusion parameters were measured according to the liver fibrosis models,and the correlation with VEGF values was analyzed.Results The animals in experimental group were successfully induced different degree of liver fibrosis.In normal group,the hepatic artery perfusion,portal vein perfusion and total hepatic blood flow were （28.25 ±2.19）ml/（min · 100 g）,（53.53 ± 10.71）ml/（min · 100 g） and （81.78 ± 18.56） ml/（min · 100 g）.The PVP and TLP values of the liver fibrosis models of 0 - 4 stages declined gradually,and it had statistical significance,while the HAP values increased.The PVP and TLP values were positive correlated with fibrosis stage.The VEGF values of the pathological models of 0 - 4 stages ascended significantly.Conclusions The dog liver fibrosis models that are similar to human hepatic fibrosis have been successfully induced by low dose CC14 and high fat diet.CT perfusion can be used to monitor the tendency of the hemodynamic in different degree of fibrosis.VEGF may play an important role during liver fibrogenesis.