CAJ | 학술논문

目的探讨3.0 T MR DWI评价兔肝VX2瘤射频消融治疗疗效的价值.方法新西兰大白兔22只.20只用于建立VX2瘤模型,2只健康正常兔用于行正常肝射频消融术对照.于VX2瘤种植后14～21 d(平均17 d),对符合实验条件瘤兔(病灶位于肝实质内,最大直径≤3 cm,坏死病灶直径≤整个病灶直径的1/2)行3.0 T常规MRI和功能DWI.对瘤兔及对照组正常兔行射频消融治疗,射频消融术后7～10 d(平均8 d)行3.0 T常规MRI及DWI.所有射频消融治疗兔行MR检查后均行病理检查.测量兔肝VX2瘤、正常兔肝射频消融治疗前后ADC值,分析兔肝VX2瘤射频消融治疗前后3.0 T MR常规成像、ADC值特征,并与病理对照.同一b值射频消融治疗后不同组织间ADC值比较采用重复测量资料方差分析.结果 20只实验组兔肝VX2瘤模型均建立成功,1例肿瘤突出于肝表面、1例肿瘤病灶出现明显坏死未纳入实验.所有18个瘤灶及2例正常兔肝射频消融均成功.兔VX2瘤T1WI序列表现为低或等信号,T2WI为高信号.肝VX2瘤兔射频消融治疗后7～10 d,射频消融病灶T1WI序列表现为低或稍高信号,T2WI为混杂信号.T2WI序列周边环形稍高信号为肉芽组织,增强扫描明显强化,T2WI序列低、中等信号为凝固性坏死.坏死组织在DWI图上为低信号,活性肿瘤组织位于病灶周边,呈结节状,在T2WI、DWI图上为等或稍高信号.肿瘤标本为灰白色,部分肿瘤组织间夹杂增生血管、少许肉芽组织.b值为600 s/mm2时,射频消融治疗后活性肿瘤组织(9只)、坏死组织(18只)、肉芽组织(18只)、正常组织(18只)ADC值分别为:(1.227±0.140)×10-3、(0.702±0.050)×10-3、(1.918±0.124)×10-3、(1.739±0.044)×10-3mm2/s,各组间ADC值差异具有统计学意义(P＜0.01).b值分别为200、400、600、800、1000 s/mm2时治疗后坏死组织、活性残留或复发肿瘤组织、肉芽组织、正常肝组织间ADC值差异具有统计学意义(P＜0.01).结论兔VX2瘤模型适合3.0 T MR评价射频消融治疗疗效的动物实验研究,对射频消融治疗基础及临床应用研究具有重要价值. 目的探討3.0 T MR DWI評價兔肝VX2瘤射頻消融治療療效的價值.方法新西蘭大白兔22隻.20隻用于建立VX2瘤模型,2隻健康正常兔用于行正常肝射頻消融術對照.于VX2瘤種植後14～21 d(平均17 d),對符閤實驗條件瘤兔(病竈位于肝實質內,最大直徑≤3 cm,壞死病竈直徑≤整箇病竈直徑的1/2)行3.0 T常規MRI和功能DWI.對瘤兔及對照組正常兔行射頻消融治療,射頻消融術後7～10 d(平均8 d)行3.0 T常規MRI及DWI.所有射頻消融治療兔行MR檢查後均行病理檢查.測量兔肝VX2瘤、正常兔肝射頻消融治療前後ADC值,分析兔肝VX2瘤射頻消融治療前後3.0 T MR常規成像、ADC值特徵,併與病理對照.同一b值射頻消融治療後不同組織間ADC值比較採用重複測量資料方差分析.結果 20隻實驗組兔肝VX2瘤模型均建立成功,1例腫瘤突齣于肝錶麵、1例腫瘤病竈齣現明顯壞死未納入實驗.所有18箇瘤竈及2例正常兔肝射頻消融均成功.兔VX2瘤T1WI序列錶現為低或等信號,T2WI為高信號.肝VX2瘤兔射頻消融治療後7～10 d,射頻消融病竈T1WI序列錶現為低或稍高信號,T2WI為混雜信號.T2WI序列週邊環形稍高信號為肉芽組織,增彊掃描明顯彊化,T2WI序列低、中等信號為凝固性壞死.壞死組織在DWI圖上為低信號,活性腫瘤組織位于病竈週邊,呈結節狀,在T2WI、DWI圖上為等或稍高信號.腫瘤標本為灰白色,部分腫瘤組織間夾雜增生血管、少許肉芽組織.b值為600 s/mm2時,射頻消融治療後活性腫瘤組織(9隻)、壞死組織(18隻)、肉芽組織(18隻)、正常組織(18隻)ADC值分彆為:(1.227±0.140)×10-3、(0.702±0.050)×10-3、(1.918±0.124)×10-3、(1.739±0.044)×10-3mm2/s,各組間ADC值差異具有統計學意義(P＜0.01).b值分彆為200、400、600、800、1000 s/mm2時治療後壞死組織、活性殘留或複髮腫瘤組織、肉芽組織、正常肝組織間ADC值差異具有統計學意義(P＜0.01).結論兔VX2瘤模型適閤3.0 T MR評價射頻消融治療療效的動物實驗研究,對射頻消融治療基礎及臨床應用研究具有重要價值.
목적 탐토3.0 T MR DWI평개토간VX2류사빈소융치료료효적개치.방법 신서란대백토22지.20지용우건립VX2류모형,2지건강정상토용우행정상간사빈소융술대조.우VX2류충식후14～21 d(평균17 d),대부합실험조건류토(병조위우간실질내,최대직경≤3 cm,배사병조직경≤정개병조직경적1/2)행3.0 T상규MRI화공능DWI.대류토급대조조정상토행사빈소융치료,사빈소융술후7～10 d(평균8 d)행3.0 T상규MRI급DWI.소유사빈소융치료토행MR검사후균행병리검사.측량토간VX2류、정상토간사빈소융치료전후ADC치,분석토간VX2류사빈소융치료전후3.0 T MR상규성상、ADC치특정,병여병리대조.동일b치사빈소융치료후불동조직간ADC치비교채용중복측량자료방차분석.결과 20지실험조토간VX2류모형균건립성공,1례종류돌출우간표면、1례종류병조출현명현배사미납입실험.소유18개류조급2례정상토간사빈소융균성공.토VX2류T1WI서렬표현위저혹등신호,T2WI위고신호.간VX2류토사빈소융치료후7～10 d,사빈소융병조T1WI서렬표현위저혹초고신호,T2WI위혼잡신호.T2WI서렬주변배형초고신호위육아조직,증강소묘명현강화,T2WI서렬저、중등신호위응고성배사.배사조직재DWI도상위저신호,활성종류조직위우병조주변,정결절상,재T2WI、DWI도상위등혹초고신호.종류표본위회백색,부분종류조직간협잡증생혈관、소허육아조직.b치위600 s/mm2시,사빈소융치료후활성종류조직(9지)、배사조직(18지)、육아조직(18지)、정상조직(18지)ADC치분별위:(1.227±0.140)×10-3、(0.702±0.050)×10-3、(1.918±0.124)×10-3、(1.739±0.044)×10-3mm2/s,각조간ADC치차이구유통계학의의(P＜0.01).b치분별위200、400、600、800、1000 s/mm2시치료후배사조직、활성잔류혹복발종류조직、육아조직、정상간조직간ADC치차이구유통계학의의(P＜0.01).결론 토VX2류모형괄합3.0 T MR평개사빈소융치료료효적동물실험연구,대사빈소융치료기출급림상응용연구구유중요개치.
Objective To evaluate 3.0 T MR DWI techniques in detecting the lesions of pre and post-radiofrequency ablation of the rabbit liver VX2 tumors. Methods Twenty two New Zealand white rabbits were used in this experiment. Twenty tumor fragments were implanted into the livers of 20 rabbits respectively. Two normal rabbits were used as controls for radiofrequency ablation of the normal liver. 3.0 T MR DWI was performed 14 to 21 days after tumor implantation (mean, 17 days) in the tumor-bearing animals. Radiofrequency ablation was performed in the 18 tumor-bearing animals and in the two healthy animals. 3.0 T MRI and DWI were performed 7 to 10 days after radiofrequency ablation (mean, 8 days).Pathology was obtained immediately after the completion of post-radiofrequency ablation MR imaging. The MRI features and ADC values of pre- and post -radiofrequency ablation lesions in the liyers with VX2 tumors and normal rabbits were analyzed and correlation was made with histopathologic findings. Analysis of variance repeated measures were performed in analyzing the differences among the ADC values of different tissues with the same b value. Results All 20 rabbit liver models of VX2 tumors were constructed successfully. One rabbit died of anesthetic overdose, another one showed necrosis within the implanted tumor. All 18 untreated VX2 tumors had predominantly low or iso-signal intensity on T1 WI and high signal intensity on T2WI. All 18 VX2 tumors and 2 normal rabbits were treated by radiofrequency ablation successfully. Lesions treated by Radiofrequency ablation displayed low signal intensity on T1 WI, and high signal intensity on T2WI. Seven to 10 days after radiofrequency ablation, lesions varied from having low signal intensity to slightly increased signal intensity on T1 WI, with areas of mixed ( high, intermediate, and low) signal intensity. A peripheral rim of high signal intensity with varying thickness on T2WI correlated with granulation tissue, which exhibited intense enhancement on contrast-enhanced images. Areas of low to intermediate signal intensity within the lesion on T2WI corresponded to coagulation necrosis. The tumor tissue appeared as areas of peripheral nedularity, with intermediate to high signal intensity on T2-weighted images and DWI. The tumor specimen was gray, among the tumor tissue, there were hyperplastic vessels,and granulation tissue. When b value was 600 s/mm2 , the ADC value of viable tumor (9 cases), necrosis (18 cases), granulation tissue ( 18 cases), normal liver tissue ( 18 cases) were ( 1. 227 ±0. 140) × 10-3,(0. 702 ± 0. 050)×10-3, ( 1.918 ± 0.124) × 10-3, ( 1. 739 ± 0. 044 ) × 10-3 mm2/s, respectively, which were statistically significant (P ＜0. 01 ). When b =200,400,600,800,1000 s/mm2, the differences of ADC values among viable tumor, granulation tissue, necrosis,normal liver tissue were also statistically significant ( P ＜0. 01 ). Conclusion The rabbit liver VX2 tumor models and 3.0 T MR DWI are important tools in the basic and clinical researches of radiofrequency ablation.