[灌注CT扫描对肝微小转移瘤大鼠肝脏血流动力学变化的影响]

[Effect of perfusion CT scan on hepatic hemodynamic changes in rats with liver micrometastases].

作者信息

Shi Gao-Feng, Wang Shi-Jie, Wang Qi, Xu Qian, Li Ru-Xun, Du Yu, Wang Ya-Ning, Li Yue-Kao, Yang Li, Zhang Jun-Jie

机构信息

CT Department, The Fourth Affiliated Hospital, Hebei Medical University, Shijiazhuang, Hebei, 050011, P. R. China.

出版信息

Ai Zheng. 2006 Jul;25(7):849-54.

PMID:16831276

Abstract

BACKGROUND & OBJECTIVE: Hepatic metastases are common for patients with malignant tumors, especially for the gastrointestinal malignancies. Early diagnosis confers better prognosis. This study was designed to investigate the hepatic hemodynamic changes by multi-slice helical perfusion CT in rats with liver micrometastatases of Walker-256 tumor cells.

METHODS

Liver micrometastatases were produced in 22 SD rats by injecting 2 x 10(7) Walker-256 cells into the spleens. The ten experimental control rats were injected with normal saline solution. Ten rats were randomized into empty self control group from the experimental group before injecting tumor cells, which were studied by CT perfusion technique before being injected tumor cells. The time-density curves of the aorta, portal vein, and liver were used to calculate liver perfusion parameters by gradient method designed for the dual blood supply. These liver perfusion parameters were hepatic arterial perfusion (HAP), portal vein perfusion (PVP), hepatic perfusion index (HPI) and total hepatic blood flow. All the parameters were compared between the groups. H&E staining method was used to confirm the micrometastases pathologically.

RESULTS

In the experimental group, 19 rats were found with micrometastases, of which the diameter was 0.5 mm to 6.6 mm. HAP was (97.67+/-31.42) ml x min(-1) x (100 ml) (-1) in metastasis group, and (43.35+/-17.39)ml x min(-1) x (100 ml) (-1) in control group, and (40.77+/-18.91) ml x min(-1) x (100 ml) (-1) in empty self control group. PVP was (295.49+/-61.85) ml x min(-1) x (100 ml) (-1) in metastasis group, and (385.7+/-71.25) ml x min(-1) x (100 ml) (-1) in control group, and (362.73+/-78.56) ml x min(-1) x (100 ml) (-1) in empty self control group, It was found that the HAP was higher in the rats with micrometastases than in those of the empty control group and also those of control group (F=47.84, P<0.000,1). While the PVP was lower in the rats with micrometastases than in those of the two control groups (F=14.10, P<0.000,1). For the total hepatic blood flow, no significant difference was found among the three groups (F=1.39, P=0.255).

CONCLUSION

Higher HAP and lower PVP was noted in the rats with micrometastases. Perfusion CT technique can be used to evaluate the hepatic hemodynamic changes and thus has a potential clinical value for early diagnosis of liver micrometastases.

摘要

背景与目的

肝转移在恶性肿瘤患者中较为常见，尤其是胃肠道恶性肿瘤患者。早期诊断可带来更好的预后。本研究旨在通过多层螺旋灌注CT研究Walker-256肿瘤细胞肝微转移大鼠的肝脏血流动力学变化。

方法

将2×10⁷个Walker-256细胞注射到22只SD大鼠的脾脏中，制造肝微转移模型。10只实验对照大鼠注射生理盐水。10只大鼠在注射肿瘤细胞前从实验组随机分为空自身对照组，在注射肿瘤细胞前用CT灌注技术进行研究。利用主动脉、门静脉和肝脏的时间-密度曲线，通过为双重血液供应设计的梯度法计算肝脏灌注参数。这些肝脏灌注参数包括肝动脉灌注（HAP）、门静脉灌注（PVP）、肝灌注指数（HPI）和肝脏总血流量。对各组之间的所有参数进行比较。采用苏木精-伊红（H&E）染色法进行病理微转移确认。

结果

实验组中，19只大鼠发现有微转移，直径为0.5mm至6.6mm。转移组的HAP为（97.67±31.42）ml·min⁻¹·(100ml)⁻¹，对照组为（43.35±17.39）ml·min⁻¹·(100ml)⁻¹，空自身对照组为（40.77±18.91）ml·min⁻¹·(100ml)⁻¹。转移组的PVP为（295.49±61.85）ml·min⁻¹·(100ml)⁻¹，对照组为（385.7±71.25）ml·min⁻¹·(100ml)⁻¹，空自身对照组为（362.73±78.56）ml·min⁻¹·(100ml)⁻¹。发现有微转移的大鼠的HAP高于空对照组和对照组大鼠（F = 47.84，P < 0.0001）。而有微转移的大鼠的PVP低于两个对照组（F = 14.10，P < 0.0001）。对于肝脏总血流量，三组之间未发现显著差异（F = 1.39，P = 0.255）。