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背景与目的:肝脏是转移性肿瘤的好发部位,尤其是胃肠道肿瘤易转移到肝脏。肝转移癌的早期发现对其诊治和预后至关重要。本研究旨在使用多层螺旋CT灌注成像技术研究大鼠Walker-256微小转移性肝癌的血流动力学变化。方法:22只经脾脏注入Walker-256(细胞含量2×107)制备成肝脏微小转移癌的大鼠为实验组;10只大鼠经脾脏注入等量生理盐水为对照组;实验组中随机选取10只注射瘤细胞前的大鼠作为空白自身对照组。CT灌注扫描后用斜率法计算得到参数包括:肝动脉灌注量(hepaticarterialperfusion,HAP)、门静脉灌注量(portalveinperfusion,PVP)、肝灌注指数(hepaticperfusionindex,HPI)、总肝灌注量。病理学检查HE染色证实转移癌的存在。结果:实验组中有19只大鼠发现转移灶,直径0.5～6.6mm。各项参数值组间比较:实验组大鼠HAP[(97.67±31.42)ml·min-1·(100ml)-1],明显高于对照组[(43.35±17.39)ml·min-1·(100ml)-1]和空白组[(40.77±18.91)ml·min-1·(100ml)-1],差异具有显著性(F=47.84,P<0.0001);对照组和空白组之间差异无显著性。实验组PVP[(295.49±61.85)ml·min-1·(100ml)-1]明显低于对照组[(385.7±71.25)ml·min-1·(100ml)-1]和空白组[(362.73±78.56)ml·min-1·(100ml)-1],差异具有显著性(F=14.10,P<0.0001),对照组和空白组差异无显著性。总肝灌注量组间比较,三组之间没有差异(F=1.39,P=0.255)。结论:大鼠微小肝转移癌表现为肝动脉灌注量的增加和门静脉灌注量的降低。CT灌注成像技术可以用来评价肝脏的血流动力学变化,对于早期诊断肝脏转移癌具有潜在的临床应用价值。
Background and Objective: The liver is a predilection site for metastatic tumors, especially gastrointestinal tumors that are easily translocated to the liver. Early detection of liver metastases is crucial for diagnosis and prognosis. This study aimed to investigate the hemodynamic changes in Walker-256 micrometastatic hepatocellular carcinoma using multi-slice spiral CT perfusion imaging. Methods: Twenty-two rats were injected with Walker-256 (cell content 2 × 107) via spleen into the experimental group with liver micrometastasis. 10 rats were injected with equal volume of normal saline as the control group. The rats in the experimental group were randomly selected 10 mice injected with tumor cells beforehand as a blank self-control group. Parameters calculated by slope method after CT perfusion scan included hepatic arterial perfusion (HAP), portal vein infusion (PVP), hepatic perfusion index (HPI) and total hepatic perfusion. Pathological examination HE staining confirmed the presence of metastatic carcinoma. RESULTS: Twenty-nine rats in the experimental group had metastases with a diameter of 0.5-6.6 mm. Compared with the control group, HAP [(97.67 ± 31.42) ml · min-1 · (100ml) -1] in the experimental group was significantly higher than that in the control group [(43.35 ± 17.39) ml · min-1 · (40.77 ± 18.91) ml · min-1 · (100ml) -1], the difference was significant (F = 47.84, P <0.0001). There was no significant difference between the control group and the blank group Significance. The level of PVP in the experimental group was significantly lower than that in the control group [(295.49 ± 61.85) ml · min -1 · (100 ml) -1] [(385.7 ± 71.25) ml · min -1 · (100ml -1)] and [362.73 ± 78.56) ml · min-1 · (100ml) -1], the difference was significant (F = 14.10, P <0.0001). There was no significant difference between the control group and the blank group. There was no difference between the three groups for total hepatic perfusion volume (F = 1.39, P = 0.255). CONCLUSIONS: The micrometastatic metastasis of the liver in rats shows an increase of hepatic artery perfusion and a decrease of portal vein perfusion. CT perfusion imaging can be used to evaluate the hemodynamic changes of the liver, which has potential clinical value for the early diagnosis of liver metastases.