新西兰兔下腔静脉内置入^(125)I粒子条的实验研究

Experimental Study of the Different Dose Iodine 125 Seeds Srand Implantation into Inferior Vena Cava in Rabbit Models

目的评估兔下腔静脉腔内置入125I粒子条的可行性、安全性,以及影像学的诊断价值。材料与方法将24只新西兰兔随机分成两组:A组(2枚粒子)和B组(4枚粒子),各12只。将6711型125I粒子制成粒子条。备好的粒子条经下腔静脉前壁荷包中央置入并悬挂固定在下腔静脉内壁。比较125I粒子条置入前后血常规及肝功能的变化;分别饲养1周、2周、4周、2个月、4个月后称体重,行实验室、多层螺旋CT(MDCT)增强扫描、DSA及组织病理学检查,两组间做比较。结果两组均未发现与125I粒子辐射相关的腹泻及死亡。各组125I粒子条置入前后及两组间体重、血常规、肝功能差异无统计学意义(P>0.05)。MDCT增强及DSA显示下腔静脉血流通畅,但CT显示粒子金属伪影严重、计数困难。大体标本示下腔静脉无穿孔、血栓形成。两组光镜下均见血管内皮细胞坏死、脱落,中膜及外膜无明显改变。两组邻近125I粒子旁肝细胞坏死明显,B组较A组严重,但随着时间的延长有所修复;远处肝脏及其他组织无异常。结论兔下腔静脉管腔内置入线状排列125I粒子条是安全、可行的。影像学尤其DSA是粒子置入术对血管影响较好的评价手段。

Objective To evaluate the safty and feasibility of the iodine 125 seed strand implantation into inferior vena cava in rabbit models.Materials and Methods 24 New Zealand white rabbits were equally and randomly divided into GroupA（two seeds） and Group B（four seeds）.Two or four 125 I seeds（model 6711） were sealed into a transparent catheter as a seed strand.The iodine 125 seeds strand was inserted into the inferior vena cava through the purse and suspensory fixed on the inner wall of the inferior vena cava.The post operation body weight,routine blood and liver function were compared with those of pre-operation respectively.Inferior vena cava DSA or MDCT examinations were performed at 1st,2nd,4th,8th and 16th week respectively.MDCT examinations were performed with plain scan,arterial phase,portal phase and venous phase enhancement for all animals and 3D MPR were acquired.Animals were killed at 1st,2nd,4th,8th and 16th week.Inferior vena cava,the vicinity liver tissue and the intestine were analyzed by the macropathology and HE stain.Results No radiation related diarrhea and death were observed in two groups.No significant changes in the body weight,routine blood and liver function was observed between two groups（P0.05）.DSA,MDCT and 3D MPR show that the inferior vena cava was patent.In macropathology,the target IVC was smooth,and there was no perforation or mural thrombosis.No adherence was observed between the seeds strand and blood vessel.The microscopic pathology showed that necrosis and exfoliation of endothelial cells in IVC were seen in two groups,and there was no obvious pathological changes in media and adventitia tunicae in all time range.The liver cells swelling and distension,lyse and necrosis were seen near the seeds strand in two groups,and Group B was more severe.Conclusion Linear iodine 125 seeds strand intraluminal implantation into the inferior vena cava is safe and feasible.