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目的应用CT灌注成像观察大鼠微小转移性肝癌所引起的血流动力学变化与肿瘤血管化程度的相关性。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只作为空白对照组。CT灌注扫描后使用斜率法得到参数包括:肝动脉灌注量、门静脉灌注量、肝灌注指数、总肝灌注量。采用免疫组织化学方法测定病理标本的微血管密度和血管内皮生长因子。结果实验组中有19只大鼠发现转移灶,直径在0.5~6.6 mm之间。各项参数值组间比较:实验组大鼠肝动脉灌注量、肝灌注指数明显高于对照组和空白组;对照组和空白组之间无显著差别。实验组门静脉灌注量明显低于对照组和空白组,对照组和空白组无显著差别。总肝灌注量组间比较,三组之间没有差别。VEGF表达程度随着实验组大鼠肝动脉灌注量增高而增高。而且VEGF不同表达程度的转移癌之间MVD的差异均有统计学差异。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。肝动脉灌注量的大小与VEGF的表达程度和MVD呈正相关。
Objective To observe the relationship between hemodynamic changes caused by micrometastatic liver cancer and the degree of tumor vascularization by CT perfusion imaging. Methods 22 rats with liver micrometastases were injected with Walker-256 (2 × 107 cells) via spleen into experimental group. Ten rats were injected with equal volume of normal saline into control group. Ten randomly selected experimental group as a blank control group. Slope method after CT perfusion scan obtained parameters include: hepatic artery perfusion, portal vein perfusion, hepatic perfusion index, total hepatic perfusion. Immunohistochemistry was used to determine the microvessel density and vascular endothelial growth factor in pathological specimens. RESULTS: Twenty-nine rats in the experimental group were found to have metastases with a diameter between 0.5 and 6.6 mm. The parameters between the groups were compared: the experimental group rats hepatic artery perfusion, liver perfusion index was significantly higher than the control group and the blank group; control group and the blank group no significant difference. The experimental group portal vein perfusion was significantly lower than the control group and the blank group, the control group and the blank group no significant difference. Total liver perfusion volume comparison between groups, there is no difference between the three groups. The expression of VEGF increased with the increase of hepatic artery perfusion in the experimental group. And the difference of MVD between metastatic carcinoma of different expression levels of VEGF has statistical difference. Conclusion Micro-metastatic liver cancer in rats showed increased hepatic arterial perfusion and decreased portal perfusion. The amount of hepatic artery perfusion was positively correlated with the expression of VEGF and MVD.