经皮经肝超声造影显像评估兔VX2肝癌腹腔淋巴结转移的实验研究

Assessment of abdominal lymph node metastasis of VX2 hepatic cancer rabbits with percutaneous transhepatic lymphosonography

目的探讨经皮经肝超声造影显像在评估兔VX2肝癌腹腔淋巴转移中的应用价值。方法新西兰大白兔30只,分为正常对照组(A组)5只,肝癌种植组(B组)25只,同时在癌组织及癌周组织注射超声造影剂Sono Vue,动态观察正常肝组织、癌组织及癌周组织的增强特点,并使用超声仪器自带造影分析软件定量分析。开腹清扫淋巴结并送病理学检查。结果 25只肝癌种植组(B组)中,无淋巴结转移(B1组)14只,淋巴结转移(B2组)11只。肝脏经皮经肝超声造影显像分为组织间隙期、弥散期、平台期、消退期4期,癌组织与癌周组织比较,超声造影剂在癌组织呈现为"快退",癌周组织能够持续增强20 min以上并逐渐消退。平台期强度(PTI)表现为癌组织、癌周组织及正常肝组织间差异有统计学意义(P<0.01),且PTI癌组织>PTI癌周组织>PTI正常肝组织。B1、B2组癌周组织及A组正常肝组织各组间的PTI差异均有统计学意义(P<0.01),且PTIB2>PTIB1>PTIA。B1组、B2组癌组织的PTI与A组比较差异有统计学意义(P<0.05),但B1、B2两组间差异无统计学意义。结论经皮经肝超声造影显像可提供肝癌腹腔淋巴转移情况的信息,为选择治疗方式及分析预后提供重要依据。

Objective To investigate the applications of percutaneous transhepatic lymphosonography in assessing abdominal lymph node metastasis of VX2 hepatic cancer rabbits. Methods A total of 30 rabbits with VX2 tumor were divided into sham group（ group A,n = 5） and hepatic cancer group（ group B,n = 25）. Sono Vue was injected into the liver parenchyma inside and around the VX2 cancer to observe the normal heptic tissues,cancerous tissues and pericancerous tissues dynamically. The changes were quantatively analyzed. Results Of the 25 rabbits in group B,11（ group B2） had lymph node metastasis while 14（ group B1） had not. Percutaneous transhepatic lymphosonography showed the liver tissues could be divided into 4 phases,interstitial space,defusing,plateau and dissipating phase. Sono Vue disappeared in cancerous tissues faster than in pericancerous tissues,in which Sono Vue sustained for 20 minutes. There were significant differences among normal heptic tissues,cancerous tissues and pericancerous tissues in plateau intensity（ PTI）（P 0. 01）,and PTI in cancerous tissues was the greatest,followed by pericancerous tissues and normal heptic tissues.There were significant differences in pericancerous tissues of group A,B1 and B2,and PTI in group B2 was the greatest,followed by group B1 and group A（ P 0. 05）. Conclusion Percutaneous transhepatic lymphosonography can provide detailed information of abdominal lymph node metastasis of hepatic cancer,which is useful for the choice of treatment and prediction of therapeutic effects.