MRI多模态成像在UTMD联合CA-(Q-D-lip)精确示踪和治疗胶质瘤中的价值

Value of MRI multi-modal imaging in precise tracing and treatment of glioma by UTMD combined with CA-(Q-D-lip)

目的探讨磁共振成像(MRI)多模态技术在超声靶向微泡爆破技术(UTMD)联合量子点(QDs)加载多西紫杉醇抗肿瘤药物[简写为CA-(Q-D-lip)]精准示踪和靶向治疗大鼠C6胶质瘤的应用价值。方法选择80只雄性成年健康SD大鼠,分为对照组及4个不同治疗组{QDs溶液+超声爆破治疗组(Q-D+UTMD组)、空白脂质体+超声爆破治疗组(Blank lip+UTMD组)、QDs脂质体+超声爆破治疗组(Q-D-lip+UTMD组)和纤连蛋白靶向肽修饰的QDs脂质体+超声爆破治疗组[CA-(Q-D-lip)+UTMD组]},每组16只。治疗组从大鼠接种C6胶质瘤细胞后第7天开始定期给药,28 d内共接受7次给药。每次给药后立即行UTMD治疗,各组给药后第7、14、21、28天进行胶质瘤MRI常规、动态增强扫描及多扩散敏感因子(b)值扩散加权成像及荧光成像。计算增强MRI后胶质瘤体积;依据时间-信号强度曲线(TIC)特征,计算早期相对信号强化率(ARSER);分析不同数学扩散模型的评价效能。荧光成像仪检测胶质瘤QDs的分布特点,胶质瘤中靶向肽脂质体的靶向性。分析各组C6胶质瘤在同一及不同时间内体积变化、TIC信号强度差值及ARSER比较、多b值扩散加权成像中的多参数差异分析。结果各组ARSER>60%。CA-(Q-D-lip)+UTMD组治疗后体积缩小最明显,ARSER最小,效果优于其他4组;CA-(Q-D-lip)+UTMD组随时间增加,表观弥散系数(ADC)、D、Dapp值整体呈上升趋势,Kapp、D*及f值呈下降趋势;其余4组随时间增加,ADC、D、Dapp值呈下降趋势,Kapp、D*及f值呈上升趋势;这些参数综合比较,ADC值相对稳定可靠,诊断效能较高;CA-(Q-D-lip)+UTMD组QDs量分布最多(第7天)。结论MRI多模态成像可精确评价CA-(Q-D-lip)+UTMD治疗胶质瘤的疗效。

Objective To explore the application value of magnetic resonance imaging(MRI)multimodal technique in ultrasound-targeted micro-bubble destruction(UTMD)technique combined with quantum dots(QDs)loading docetaxel antineoplastic drug[CA-(Q-D-lip)]to accurately trace and target the treatment of rat C6 glioma.Methods A total of 80 male adult healthy SD rats were divided into the control group and four different treatment groups{QDs solution+ultrasonic blasting treatment group(Q-D+UTMD group),blank liposome+ultrasonic blasting treatment group(Blank lip+UTMD group),QDs liposome+ultrasonic blasting treatment group(QD-lip+UTMD group)and fibronectin targeting peptide-modified QDs liposomes+ultrasonic blast therapy group[CA-(QD-lip)+UTMD group]},with 16 rats in each group.Starting from the 7th day after the rats were inoculated with C6 glioma cells,the treatment group received regular 7 doses within 4 weeks(28 days).After each administration,the UTMD treatment was performed immediately.The routine MRI,dynamic enhanced scanning,multi-diffusion sensitive factor(b)-value diffusion-weighted imaging and fluorescence imaging were performed on rat glioma on seven,14,21 and 28 days after administration.Glioma volume after enhanced MRI was calculated;the relative signal enhancement ratio in the arterial phase(ARSER)was calculated,based on the characteristics of the time-signal intensity curve(TIC);and the evaluation efficacy of different mathematical diffusion models was analyzed.The fluorescence imager detected the distribution characteristics of glioma QDs,and the targeting properties of targeting peptide liposomes in glioma.The volume change,TIC signal intensity difference,ARSER comparison and the multi-parameter difference of Multi-b value diffusion-weighted imaging of C6 glioma between all the groups at the same and different time were analyzed.Results ARSER was performed at>60%in each group.CA-(QD-lip)+UTMD group had the most obvious volume reduction after treatment,ARSER was the smallest,and the effect was better than that of the other four groups.CA-(QD-lip)+UTMD group increased with time;apparent diffusion coefficient(ADC),D and Dapp value showed overall upward trend;and Kapp,D*and f values showed a downward trend.The other four groups increased with time;ADC,D,and Dapp values showed a downward trend,and Kapp,D*and f values showed an upward trend.A comprehensive comparison of these parameters showed that ADC value was relatively stable and reliable with high diagnostic efficacy.CA-(QD-lip)+UTMD group had the most QDs distribution(day 7).Conclusion MRI multimodal imaging can accurately evaluate the efficacy of CA-(Q-D-lip)combined with UTMD in the treatment of glioma.