磁共振波谱在5-氟尿嘧啶热化疗治疗兔肝VX2移植瘤效果评价中的应用

Curative evaluation of magnetic resonance spectroscopy on hepatic VX2 carcinoma implanted in rabbit after 5-Fu interventional thermochemotherapy

目的 比较兔肝VX2移植瘤经介入性热化疗（ITC）治疗前后1H-MRS主要代谢物的变化,并与细胞凋亡指数（AI）进行相关性分析.方法 选取新西兰大白兔20只,采用组织块种植的方法成功制成兔VX2肝癌模型,10d后,待肿瘤直径≥10 mm时,分别于治疗前1天、治疗后第14天行常规磁共振成像（MRI）及磁共振波谱（MRS）扫描.使用Philips 1.5T MR成像仪,选取病灶不同感兴趣区（ROI）,分别测量治疗前、后不同ROI的观察肿瘤治疗前后的胆碱（Cho）峰值与脂质（Lip）峰值及两者比值的变化,免疫组织化学法及HE染色检测肿瘤细胞AI,并与MRS结果进行对照,分析不同ROI的主要代谢物变化规律.结果 在成功获得的1H-MRS波谱图中多数可见到6个主要的代谢物波峰,治疗前Cho峰、Lip峰均升高;治疗后Cho峰值较治疗前下降、Lip峰值则进一步升高,Cho/Lip比值降低,两两比较差异均有统计学意义（P＜0.05）;治疗后Cho/Lip峰值比与AI值呈负相关（r=-0.56,P=0.02）.结论 兔肝VX2移植瘤不同ROI的1H-MRS主要代谢物的变化情况与肿瘤细胞AI表达程度及范围一致;1H-MRS能反映VX2移植瘤ITC治疗前后肿瘤细胞凋亡和能量代谢变化情况.

Objective To compare magnetic resonance spectroscopy （MRS） characteristics and changes before and after 5-Fu interventional thermochemotherapy （ITC） as well as to analyze the correlation of Cho/Lip and apoptosis index （AI） in hepatic VX2 carcinoma animal model.Methods 20 rabbit models of hepatic VX2 carcinoma were implanted successfully.Ten days later,as tumor diameter≥ 10 mm,routine scan and 1H-MRS were performed before one day and after 14 days on all of rabbits by Philips 1.5T MR scanner.The changes of Cho peak,Lip peak and the ratio of Cho/Lip before and after the treatment were analyzed.Specimens of AI were examined and compared with the ratio of Cho/Lip.Results The Cho peak and Lip peak were increased before ITC.After ITC,the Cho peak and the ratio of Cho/Lip decreased than before.The Lip peak was further increased than that of before.AI was correlated negatively with the ratio of Cho/Lip （r =-0.56,P =0.02）.Conclusions The metabolites of different ROI are matched with the levels and scopes of AI.1H-MRS can be used to evaluate tumor cell apoptosis and energy metabolism changes of the rabbit models of hepatic VX2 carcinoma with the treatment.