全肝容积灌注CT成像评估兔肝血流灌注及体积对肿瘤坏死率的影响

Evaluating the effect of liver blood flow perfusion and volume on the tumor necrosis rate in rabbits via total liver volume perfusion CT

目的探讨全肝容积灌注CT成像(VPCT)评估兔肝血流灌注及体积对肿瘤坏死率的影响。方法采用兔肝VX2移植瘤作为实验组,并设立对照组。实验组及假手术对照组在术后14 d通过全肝VPCT并获得相应的灌注参数,测量并计算实验组肿瘤体积(TV)、肿瘤坏死率(TNR)。检查完后对所有实验组肿瘤标本进行病理学观察。结果实验组癌组织与对照组肝组织灌注血流量(BF)、灌注血容量(BV)、动脉灌注量(ALP)、门静脉灌注量(PVP)、动脉灌注指数(HPI)比较,差异均有统计学意义(P<0.05),实验组癌旁组织与对照组肝组织BF、BV、ALP、PVP、HPI比较,差异均无统计学意义(P>0.05)。Pearson相关性分析显示,TNR与ALP、HPI呈负相关(r=-0.410和-0.356,均P<0.05),TNR与BF、BV、PVP无相关性(r=-0.016、-0.155和0.256,均P>0.05);TV与BF、BV、PVP、ALP、HPI无相关性(r=0.062、0.292、0.140、0.142和0.014,均P>0.05);肝VX2移植瘤TNR与TV无相关性(r=-0.098,P>0.05)。HE染色发现肿瘤边缘区为富含血管的环形癌组织,中央为坏死区。结论兔肝VX2移植瘤TNR与全肝VPCT反映的肿瘤动脉灌注高低有关,与TV无明显关联。

Objective To evaluate the effect of liver blood flow perfusion and volume on the tumor necrosis rate(TNR)in rabbits via total liver volume perfusion CT(VPCT).Methods The rabbit VX2 liver tumor models were established and set as the experimental group,and a control group was also set up.Fourteen days after the operation,total liver VPCT was performed on rabbits in the experimental group and the sham operation group to obtain perfusion-related parameters,and the tumor volume(TV)and TNR of rabbits in the experimental group were measured and calculated.After the examination,pathological observation was carried out on all tumor samples in the experimental group.Results There were significant differences in the liver blood flow(BF),blood volume(BV),arterial liver perfusion(ALP),portal vein perfusion(PLP),and hepatic perfusion index(HPI)between tumor tissues in the experimental group and liver tissues in the control group(P<0.05).There was no difference in BF,BV,ALP,PVP and HPI between adjacent tissues in the experimental group and liver tissues in the control group(P>0.05).Pearson correlation analysis revealed that TNA was negatively correlated with ALP and HPI(r=-0.410 and-0.356,both P<0.05)but not correlated with BF,BV or PVP(r=-0.016,-0.155 and 0.256,all P>0.05).TV was not correlated with BF, BV, PVP, ALP or HPI (r = 0.062, 0.292, 0.140, 0.142 and 0.014, all P > 0.05). Besides, TNR was not correlated with TV of the VX2 liver tumors (r = -0.098, P > 0.05). HE staining showed that the tumor edge was in a circular shape and rich in blood vessels, and that the center area was necrotic. Conclusions The rabbit VX2 liver tumor models was related to the level of tumor arterial perfusion reflected by the total liver VPCT, but not significantly correlated with TV.