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[CT肝脏全灌注成像评估经动脉化疗栓塞联合阿帕替尼对兔VX2肝癌的疗效]

[Evaluation of total liver perfusion imaging of CT for efficacy of transcatheter arterial chemoembolization combined with apatinib on rabbit VX2 liver tumors].

作者信息

Liu Xiao, Deng Lingling, Guo Rui, Liang Qi, Liu Sheng, Hu Pengzhi

机构信息

Department of Radiology, Third Xiangya Hospital, Central South University, Changsha 410013, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019 May 28;44(5):477-484. doi: 10.11817/j.issn.1672-7347.2019.05.002.

Abstract

To investigate the value of the total liver CT perfusion imaging in the evaluation of rabbit VX2 liver tumors treated with TACE and apatinib.
 Methods: Thirty-six rabbit VX2 liver cancer models were established and randomly divided into 4 groups. Group A: simple TACE group; Group B: simple oral administration of apatinib mesylate; Group C: TACE + oral apatinib mesylate; Group D: control group, administration of saline. CT perfusion imaging (CTPI) was performed before treatment and on the 7 and 14 days after the treatment to acquire perfusion parameters including blood flow (BF), blood volume (BV), MTT (mean transit time), surface permeability (PS), and hepatic artery fraction (HAF). One tumor rabbit was sacrificed in each group after the first perfusion scan, and the remaining tumor rabbits were sacrificed after the last perfusion scan on the 14th day of the treatment. The borders of the tumors were stained immunohistochemically, and microvascular density (MVD) was measured by anti-CD34. The differences of perfusion parameters were compared to evaluate the liver hemodynamic changes, and statistical repeated measurement variance analysist correlation analysis were performed.
 Results: There were no significant differences in CTPI parameters of BF, BV, MTT, HAF and PS between the 4 groups before treatment (P>0.05). After the treatment, HB, HAF and PS were decreased significantly in Group A, B, and C and slightly increased in the Group D. The value of MVD after 14 d treatment was 80.1±16.4 in Group A, 50.2±11.2 in Group B, 27.4±9.7 in Group C, 68.7±12.7 in Group D, respectively. The value of MVD in the Group C were significantly lower than that in Group A, B, and D. It showed positive correlation between BF, HAF, PS and MVD in Group B, C, and D, and there was no significant correlation between BV, MTT and MVD. It showed no significant correlation between MVD and each CTPI parameter in Group A.
 Conclusion: Total liver CT perfusion can quantitatively evaluate the blood perfusion information of rabbit liver VX2 tumor after TACE. TACE combined with oral apatinib can effectively inhibit tumor growth and improve the therapeutic effect of VX2 tumor.

摘要

探讨肝脏CT灌注成像在评价经肝动脉化疗栓塞术(TACE)及阿帕替尼治疗兔VX2肝癌中的价值。方法:建立36只兔VX2肝癌模型,随机分为4组。A组:单纯TACE组;B组:单纯口服甲磺酸阿帕替尼组;C组:TACE+口服甲磺酸阿帕替尼组;D组:对照组,给予生理盐水。在治疗前及治疗后7天、14天进行CT灌注成像(CTPI),获取灌注参数,包括血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)及肝动脉分数(HAF)。每组在首次灌注扫描后处死1只荷瘤兔,其余荷瘤兔在治疗第14天最后一次灌注扫描后处死。对肿瘤边界进行免疫组织化学染色,用抗CD34检测微血管密度(MVD)。比较灌注参数差异以评估肝脏血流动力学变化,并进行统计学重复测量方差分析及相关性分析。结果:治疗前4组的BF、BV、MTT、HAF及PS的CTPI参数比较,差异均无统计学意义(P>0.05)。治疗后,A、B、C组的HB、HAF及PS均显著降低,D组略有升高。治疗14天后,A组MVD值为80.1±16.4,B组为50.2±11.2,C组为27.4±9.7,D组为68.7±12.7。C组MVD值显著低于A、B、D组。B、C、D组中BF、HAF、PS与MVD呈正相关,BV、MTT与MVD无显著相关性。A组中MVD与各CTPI参数无显著相关性。结论:肝脏CT灌注成像可定量评估TACE术后兔肝脏VX2肿瘤的血流灌注情况。TACE联合口服阿帕替尼可有效抑制肿瘤生长,提高VX2肿瘤的治疗效果。

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