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目的研究全肝 MR 灌注成像(MRPI)早期监视兔肝VX_2瘤经皮酒精注射(PEI)疗效的价值。方法新西兰大白兔10只,经开腹手术于肝内注射VX_2肿瘤细胞悬液0.1 ml,分别在种瘤后第2、3周进行 MRT_1WI、T_2WI 检查监视肿瘤生长情况。在种瘤后第3周时,于 CT 引导下,于肿瘤一侧的早期强化最明显处注射无水乙醇1.0 ml,治疗1周后应用 MRPI 观察治疗效果。灌注参数包括:对比剂到达时间(T0)和最大上升斜率(SS),应用 t 检验比较治疗区与肿瘤未治疗区的灌注参数。结果 10只兔肿瘤均种植成功,第3周时肿瘤直径(2.6±0.6)cm。治疗过程中3只兔死亡,PEI 治疗1周后的治疗区呈无或低度强化。肿瘤未治区与治疗区的 T0分别为(16.0±1.2)、(50.8±5.9)s,SS 分别为38.9±2.2、6.0±1.2,差异均有统计学意义(t 值分别为15.8、-39.6,P 值均<0.05)。常规 T_1WI、T_2WI 无法清晰显示治疗区与未治疗区的差异。结论全肝 MRPI 可以较敏感的早期监测PEI 疗效,早期强化的消失可作为 PEI 治疗有效的标志。
Objective To investigate the value of percutaneous ethanol injection (PEI) for early monitoring of hepatic VX2 tumors in rabbits with whole-body MR perfusion imaging (MRPI). Methods Ten New Zealand white rabbits were injected intraperitoneally with 0.1 ml of VX_2 tumor cell suspension in the liver. MRT_1WI and T_2WI were performed at the second and third week after the tumor implantation to monitor the tumor growth. At 3 weeks after the tumor implantation, under the guidance of CT, 1.0 ml of absolute ethanol was injected at the most obvious early stage of the tumor side. After 1 week of treatment, MRPI was used to observe the therapeutic effect. Perfusion parameters included: contrast agent arrival time (T0) and maximum ascent slope (SS), and t-test was used to compare perfusion parameters in treatment and untreated areas. Results All 10 rabbits were successfully treated with tumor. The diameter of the tumor in the third week was (2.6 ± 0.6) cm. Three rabbits died during the course of treatment, and the area treated with PEI for one week showed no or low enhancement. T0 was (16.0 ± 1.2) and (50.8 ± 5.9) s in the tumor-untreated and treated areas, respectively, and the differences were statistically significant (t = 15.8 and -39.6 , P <0.05). Conventional T_1WI, T_2WI can not clearly show the difference between treated and untreated areas. Conclusion The whole liver MRPI can be more sensitive early monitoring of the efficacy of PEI, early disappearance of enhanced PEI can be treated as a valid sign.