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目的观察兔VX2肝癌射频消融(RFA)后的MRI动态变化,并与病理所见相对照,探讨MRI评价肝癌RFA疗效的价值。方法采用生理盐水与VX2瘤块混悬液注射法复制肝肿瘤动物模型24只。开腹直视下对24只兔肝癌进行RFA,并将其随机分为4组,分别于术后即刻、术后1周、2周和4周进行MR平扫及增强扫描检查;之后处死实验兔,进行大体病理和光镜检查。结果MRI表现为病灶T1WI中央低信号,外周高信号,T2WI中央高信号,外周低信号,增强扫描病灶外周环形强化,中央无强化。光镜下消融灶呈凝固性坏死,术后即刻组外周见少许中性粒细胞、巨噬细胞浸润,肝窦扩张充血;术后1周组外周见炎性细胞浸润及少许纤维肉芽组织增生;MRI表现为病灶T1WI呈稍低信号,T2WI呈稍高信号,增强扫描病灶周边呈环状强化,中央无强化。术后2周组外周见淋巴细胞、浆细胞、多核巨细胞浸润及梭形纤维组织增生;MRI表现为病灶T1WI稍低信号,T2WI混杂信号影,向外为等低信号包膜,增强扫描病灶周边环状强化,中央无强化。术后4周组外周见大量纤维肉芽组织增生;MRI表现为病灶T1WI低信号,T2WI由内向外呈低信号-稍高信号-线状高信号环,增强扫描病灶周边环状强化,中央无强化。本组实验中17只实验兔病理学发现有肿瘤残留,MRI表现为T1WI稍低信号,T2WI高信号,增强扫描呈结节状或厚度不均的环状强化。结论MRI可全面评价RFA后病灶的变化,及时发现肝癌残存与复发。
Objective To observe the MRI dynamic changes of rabbit VX2 liver cancer after radiofrequency ablation (RFA) and to compare with the pathological findings to evaluate the value of MRI in evaluating the efficacy of RFA for liver cancer. Methods Twenty-four liver tumor animal models were injected with normal saline and VX2 tumor suspension. Twenty-four rabbits with open liver cancer underwent open-label RFA and were randomly divided into 4 groups: MR plain scan and enhanced scan were performed immediately after operation, 1 week, 2 weeks and 4 weeks after operation. After that, Rabbit, general pathology and light microscopy. Results MRI manifestations of central lesion T1WI low signal, high signal peripheral, T2WI central high signal, peripheral low signal, enhanced scan peripheral ring enhancement, central no enhancement. In the light microscope, the lesions showed coagulation necrosis. A small amount of neutrophils and macrophages were infiltrated and the hepatic sinusoids were dilated and hyperextected immediately after the operation. Inflammatory cells infiltration and a few fibrous granulation tissue hyperplasia were found in the periphery of the group 1 week after operation. MRI showed lesser T1WI lesion was slightly lower signal, T2WI was slightly higher signal enhancement enhanced lesion surrounding ring-like enhancement, the central no strengthening. Surrounding 2 weeks after operation, lymphocytes, plasma cells, multinucleated giant cell infiltration and fibrosis of spindle were observed. MRI showed lesser T1WI signal and T2WI mixed signal, Around the ring-shaped enhancement, the central no strengthening. A large number of fibrous granulation tissue hyperplasia was observed in the periphery of the 4th week after operation. MRI showed low signal intensity of T1WI, low signal intensity of T2WI from inside to outside - slightly higher signal - linear high signal ring, enhanced circular enhancement around the lesion, . Twenty-seven experimental rabbits in this experiment were found to have tumor residues in their pathology. MRI showed a slightly lower T1WI signal and a T2WI high signal, enhanced scan showed nodular or uneven thickness annular enhancement. Conclusion MRI can completely evaluate the changes of lesions after RFA and find out the recurrence and recurrence of liver cancer in time.