Department of Radiology, Second Affiliated Hospital, Harbin Medical University, Harbin 150086, China.
Hepatobiliary Pancreat Dis Int. 2012 Aug 15;11(4):407-11. doi: 10.1016/s1499-3872(12)60199-4.
Early detection and treatment of hepatocellular carcinoma is crucial to improving the patients' survival. The hemodynamic changes caused by tumors can be serially measured using CT perfusion. In this study, we used a CT perfusion technique to demonstrate the changes of hepatic hemodynamics in early tumor growth, as a proof-of-concept study for human early hepatocellular carcinoma.
VX2 tumors were implanted in the liver of ten New Zealand rabbits. CT perfusion scans were made 1 week (early) and 2 weeks (late) after tumor implantation. Ten normal rabbits served as controls. CT perfusion parameters were obtained at the tumor rim, normal tissue surrounding the tumor, and control liver; the parameters were hepatic blood flow, hepatic blood volume, mean transit time, permeability of capillary vessel surface, hepatic arterial index, hepatic arterial perfusion and hepatic portal perfusion. Microvessel density and vascular endothelial growth factor were correlated.
At the tumor rim, compared to the controls, hepatic blood flow, hepatic blood volume, permeability of capillary vessel surface, hepatic arterial index, and hepatic arterial perfusion increased, while mean transit time and hepatic portal perfusion decreased on both early and late scans (P<0.05). Hepatic arterial index increased (135%, P<0.05), combined with a sharp increase in hepatic arterial perfusion (182%, P<0.05) and a marked decrease in hepatic portal perfusion (-76%, P<0.05) at 2 weeks rather than at 1 week (P<0.05). Microvessel density and vascular endothelial growth factor showed significant linear correlations with hepatic blood flow, permeability of capillary vessel surface and hepatic arterial index, but not with hepatic blood volume or mean transit time.
The CT perfusion technique demonstrated early changes of hepatic hemodynamics in this tumor model as proof-of-concept for early hepatocellular carcinoma detection in humans.
早期发现和治疗肝细胞癌对于提高患者的生存率至关重要。肿瘤引起的血流动力学变化可以通过 CT 灌注连续测量。在这项研究中，我们使用 CT 灌注技术来证明肿瘤早期生长时肝血流动力学的变化，作为人类早期肝细胞癌的概念验证研究。
将 VX2 肿瘤植入 10 只新西兰兔的肝脏中。在肿瘤植入后 1 周（早期）和 2 周（晚期）进行 CT 灌注扫描。10 只正常兔作为对照。在肿瘤边缘、肿瘤周围正常组织和对照肝中获得 CT 灌注参数；参数包括肝血流量、肝血容量、平均通过时间、毛细血管表面通透性、肝动脉指数、肝动脉灌注和肝门静脉灌注。微血管密度和血管内皮生长因子相关。
在肿瘤边缘，与对照组相比，早期和晚期扫描时肝血流量、肝血容量、毛细血管表面通透性、肝动脉指数和肝动脉灌注增加，而平均通过时间和肝门静脉灌注减少（P<0.05）。肝动脉指数增加（135%，P<0.05），肝动脉灌注增加（182%，P<0.05），肝门静脉灌注减少（-76%，P<0.05），2 周时比 1 周时更为明显（P<0.05）。微血管密度和血管内皮生长因子与肝血流量、毛细血管表面通透性和肝动脉指数呈显著线性相关，但与肝血容量或平均通过时间无关。
CT 灌注技术在该肿瘤模型中证明了肝血流动力学的早期变化，为人类早期肝细胞癌检测提供了概念验证。
