CAJ | 학술논문

目的：建立兔软组织 VX2肿瘤模型,并在 MR介导下行无水乙醇瘤内注射消融治疗,为后期功能性 MRI评价疗效奠定基础。方法15只健康新西兰大白兔,雌雄不限,体重2.5~3 kg,在其右侧后大腿内侧肌肉内注入 VX2肿瘤细胞悬浮液各约0.2 mL,在种植肿瘤后的第14天行常规MR扫描,观察肿瘤种植的成功率及肿瘤的形态、大小、信号特点等。扫描后的第2天再在MR介导下行无水乙醇瘤内注射消融治疗。利用T2 WI作为导引及监测手段,将带侧孔的MR兼容穿刺针刺入病灶中心,按肿瘤直径1 mL/cm的量向瘤内缓慢注射无水乙醇,对肿瘤进行消融治疗。观察术前、术后肿瘤的形态特征、信号特征和病理特征。结果15只兔右侧后大腿内侧种植肿瘤均成功。常规 MR扫描肿块呈类圆形,直径约3~4 cm,T1 WI 肿瘤呈等信号或稍低信号,肿瘤中心可见更低信号的坏死区。T2 WI肿瘤呈高信号,中心坏死区为更高信号。肿瘤周边见高信号的水肿带；15只兔均成功进行了MR介导下的无水乙醇瘤内注射消融术,术中注射无水乙醇平均3.5 mL。T2 WI能清晰地监测无水乙醇在瘤内的弥散和分布。病理检查示：术前肿块周边肿瘤细胞密集,排列呈巢状,肿瘤细胞核大而深染,部分可见核分裂象。肿块中心可见少许黄白色豆腐渣样坏死组织。术后10 d肿块周边肿瘤组织大部分凝固性坏死崩解,肿瘤坏死率约85%~90%,仅见少数残存的肿瘤细胞,肿块中心坏死范围较术前明显增大。结论兔软组织 VX2肿瘤模型的建立操作简单,成瘤率高,是适合用作评价肿瘤疗效的动物模型；MR T2 WI可以清晰地监测无水乙醇在瘤内的弥散和分布,是一种好的导引和监测肿瘤消融治疗的影像学方法。
목적：건립토연조직 VX2종류모형,병재 MR개도하행무수을순류내주사소융치료,위후기공능성 MRI평개료효전정기출。방법15지건강신서란대백토,자웅불한,체중2.5~3 kg,재기우측후대퇴내측기육내주입 VX2종류세포현부액각약0.2 mL,재충식종류후적제14천행상규MR소묘,관찰종류충식적성공솔급종류적형태、대소、신호특점등。소묘후적제2천재재MR개도하행무수을순류내주사소융치료。이용T2 WI작위도인급감측수단,장대측공적MR겸용천자침자입병조중심,안종류직경1 mL/cm적량향류내완만주사무수을순,대종류진행소융치료。관찰술전、술후종류적형태특정、신호특정화병리특정。결과15지토우측후대퇴내측충식종류균성공。상규 MR소묘종괴정류원형,직경약3~4 cm,T1 WI 종류정등신호혹초저신호,종류중심가견경저신호적배사구。T2 WI종류정고신호,중심배사구위경고신호。종류주변견고신호적수종대；15지토균성공진행료MR개도하적무수을순류내주사소융술,술중주사무수을순평균3.5 mL。T2 WI능청석지감측무수을순재류내적미산화분포。병리검사시：술전종괴주변종류세포밀집,배렬정소상,종류세포핵대이심염,부분가견핵분렬상。종괴중심가견소허황백색두부사양배사조직。술후10 d종괴주변종류조직대부분응고성배사붕해,종류배사솔약85%~90%,부견소수잔존적종류세포,종괴중심배사범위교술전명현증대。결론토연조직 VX2종류모형적건립조작간단,성류솔고,시괄합용작평개종류료효적동물모형；MR T2 WI가이청석지감측무수을순재류내적미산화분포,시일충호적도인화감측종류소융치료적영상학방법。
Objective Establish rabbit VX2 soft tissue tumor model,and treat it with percutaneous ethanol injection(PEI)under the guidance of magnetic resonance imaging.Make ready for the therapeutic evaluation with functional magnetic resonance imaging. Methods Fifteen healthy New Zealand white rabbits were included in this study.0.2 mL tumor tissue suspensions were injected into the rabbits’posterior limb.14 days later,all rabbits were underwent conventional MRI examination.PET were performed to all the tumors under the guidance of MRI in the next day of the examination.T2 WI was used as guidance and monitoring means.MR com-patible puncture needle with lateral hole was stabed into the lesion center,and inj ected anhydrous ethanol according to the volume of tumors’diameter (1 mL/cm )slowly.the tumors signal characteristics,morphological feature and pathological feature were ob-served pre and post-operation.Results All of the 1 5 rabbits were established soft tissue tumor model successfully;the success rate is 100%.The tumors were oval or round,3-4 cm in diam.MRI scanning showed low signal on T1 WI and high signal on T2 WI be-fore PEI.PEI was performed to all the tumors under the guidance of MR successfully with 3.5 mL ethanol injected into the tumors in average.T2 WI could monitor the ethanol in dispersion and distribution within the tumors clearly.Histologically,tumors were composed of large,uniform,oval/round cells arranged in solid nests which was intensive in the periphery of tumors.Necrosis tissue was apparent in the center of the tumors.10 days after operation,most tissue in the periphery of tumors was coagulative necrosis , only a few tumor cells left.Ranges of necrosis in the tumors center were obviously increased compared with pre-operation.Conclusion Rabbit VX2 tumor of soft tissue model is suitable for the therapeutic evaluation of tumor .It is an animal model which has the characteristic of simple to operate and high rate of suc-cessful.MR T2 WI can monitor the ethanol in dispersion and distribution within the tumors clearly.It is a good guidance and monitoring imaging method of tumor ablation.