CAJ | 학술논문

　　目的比较分析兔肝VX2瘤行高能聚焦超声(HIFU)治疗前后不同ROI的MR灌注加权成像(PWI)变化特点，并与微血管密度(MVD)进行比较，探讨两者的相关性。材料与方法新西兰大白兔42只，采用组织块种植的方法成功制成40只兔VX2肝癌模型，随机分为治疗组20只，对照组20只，治疗组行HIFU治疗。待肿瘤直径≥10 mm时，分别于治疗前、治疗后14 d对两组行常规MRI及PWI。MR扫描使用Philips 1.5 T MR成像仪，PWI采用SE-EPI序列，信号强度-时间曲线的最大信号下降斜率(SRSmax)作为定量指标，选取病灶与周围正常肝组织的ROI，分别测量治疗前、后不同ROI的血流灌注值。标本行免疫组化检测，并与PWI结果进行对照，分析不同ROI的SRSmax变化规律，进行统计学分析。结果40只兔肝癌模型共发现48个瘤灶，其中33只瘤兔共36个瘤灶纳入最后数据分析。T2WI上，瘤灶信号呈不均匀高、低混杂信号；血流灌注图上不同ROI血流灌注程度及强度均有差异。治疗组治疗前后肿瘤中央区、周边区SRSmax值差异有统计学意义(P<0.05)；对照组前、后两次PWI，肿瘤中央区SRSmax值两两比较差异有统计学意义(P<0.05)；治疗后治疗组与对照组瘤周区的SRSmax值两两比较差异有统计学意义(P<0.05)；治疗组肿瘤周边区的SRSmax值与MVD检测结果呈正相关(r＝0.78，P=0.01)。结论兔肝VX2瘤各ROI的PWI表现与MVD表达程度、范围一致；PWI能反映VX2癌HIFU治疗前后肿瘤的血管生成、破坏状况。
　　목적비교분석토간VX2류행고능취초초성(HIFU)치료전후불동ROI적MR관주가권성상(PWI)변화특점，병여미혈관밀도(MVD)진행비교，탐토량자적상관성。재료여방법신서란대백토42지，채용조직괴충식적방법성공제성40지토VX2간암모형，수궤분위치료조20지，대조조20지，치료조행HIFU치료。대종류직경≥10 mm시，분별우치료전、치료후14 d대량조행상규MRI급PWI。MR소묘사용Philips 1.5 T MR성상의，PWI채용SE-EPI서렬，신호강도-시간곡선적최대신호하강사솔(SRSmax)작위정량지표，선취병조여주위정상간조직적ROI，분별측량치료전、후불동ROI적혈류관주치。표본행면역조화검측，병여PWI결과진행대조，분석불동ROI적SRSmax변화규률，진행통계학분석。결과40지토간암모형공발현48개류조，기중33지류토공36개류조납입최후수거분석。T2WI상，류조신호정불균균고、저혼잡신호；혈류관주도상불동ROI혈류관주정도급강도균유차이。치료조치료전후종류중앙구、주변구SRSmax치차이유통계학의의(P<0.05)；대조조전、후량차PWI，종류중앙구SRSmax치량량비교차이유통계학의의(P<0.05)；치료후치료조여대조조류주구적SRSmax치량량비교차이유통계학의의(P<0.05)；치료조종류주변구적SRSmax치여MVD검측결과정정상관(r＝0.78，P=0.01)。결론토간VX2류각ROI적PWI표현여MVD표체정도、범위일치；PWI능반영VX2암HIFU치료전후종류적혈관생성、파배상황。
Objective: Compare perfusion-weighted imaging (PWI) characteristics and parameters changes with before and after high intensity focused ultrasound (HIFU), supposed to discuss the correlation of Maximal signal reduction slope (SRSmax) and microvessel density (MVD). Materials and Methods:Forty rabbit models of hepatic VX2 tumors were implated successfully, two weeks later, after routine scans were performed on 1.5 T MR scanner, using EPI-SE series, 40 New Zealand white rabbits with VX2 carcinoma were divided randomly into treatment group 20, control group 20, HIFU with treatment group. Perfusion-weighted imaging and enhanced scan were performed 14 d before and after HIFU with both groups. Select the region of interest (ROI) of the central of tumor, surrounding of tumor and paratumor parenchyma. SRSmax of the signal intensity versus time curves were created as quantitative variable. Analyze the SRSmax change degrees and regularities of different ROI. specimens of MVD were examined and compared with PWI. Results: Forty-eight lesions were detected in 40 rabbit models, and 36 lesions in 33 rabbit models were statistical analysis ifnally. Tumor showed heterogeneous were mixed with high signal, normal signal and low signal, the degrees and intensity of blood perfusion in different ROI were different. After HIFU, the SRSmax value of central and surrounding of tumor were statistically decreased than that before HIFU (P<0.05). In control group, the SRSmax value of central of tumor with second were statistically decreased than the first (P<0.05). The SRSmax value of surrounding of tumor in HIFU group were statistically decreased than that of control group (P<0.05). The SRSmax and MVD correlation analysis showed that they were positively correlated with surrounding of tumor in HIFU group (r=0.78, P=0.01). Conclusions:The degrees of blood perfusion of different ROI were consistented with the results of MVD. PWI on VX2 carcinomas are matched with the levels and scopes of necrosis, PWI can be used in evaluating the liver tumor angiogenesis and angioruin with the treatment of HIFU.