CAJ | 학술논문

目的：通过DWI监测单次不同剂量照射下兔VX2肝癌的改变，并与病理比较。方法：40只兔VX2肝癌待肿瘤直径≥1 cm时，随机分为2组行立体定向放疗，放疗剂量分别为10 Gy、20 Gy，单次放疗，放疗后不同时间点1d、5d、10d、15d分别行 MR扫描，测量VX2肿瘤、肝脏感兴趣区（ROI）的ADC值，并计算两者比值。标本采用DNA缺口末端标记（TUNEL）法检测计算凋亡指数，并进行统计学分析。结果：40只肝癌模型共发现48个病灶。放疗后1d、15d 10Gy组与20Gy组ADC比值、凋亡指数的差异无统计学意义（P＞0．05），放疗后5d、10d 10Gy组与20Gy组ADC比值、凋亡指数有显著性差异（P＜0．05），认为20Gy组ADC 比值显著高于10Gy组。结论：DWI 可以从分子水平监测不同剂量放疗后VX2肝癌的动态变化，适当提高放疗剂量可以使细胞凋亡增加，细胞坏死、崩解更彻底，但有可能增加了放疗毒性。
목적：통과DWI감측단차불동제량조사하토VX2간암적개변，병여병리비교。방법：40지토VX2간암대종류직경≥1 cm시，수궤분위2조행입체정향방료，방료제량분별위10 Gy、20 Gy，단차방료，방료후불동시간점1d、5d、10d、15d분별행 MR소묘，측량VX2종류、간장감흥취구（ROI）적ADC치，병계산량자비치。표본채용DNA결구말단표기（TUNEL）법검측계산조망지수，병진행통계학분석。결과：40지간암모형공발현48개병조。방료후1d、15d 10Gy조여20Gy조ADC비치、조망지수적차이무통계학의의（P＞0．05），방료후5d、10d 10Gy조여20Gy조ADC비치、조망지수유현저성차이（P＜0．05），인위20Gy조ADC 비치현저고우10Gy조。결론：DWI 가이종분자수평감측불동제량방료후VX2간암적동태변화，괄당제고방료제량가이사세포조망증가，세포배사、붕해경철저，단유가능증가료방료독성。
Objective:To evaluate the changes of hepatic VX2 tumors in campariation of the results of DWI and pa-thology after different doses of single stereotactic radiotherapy.Methods:When the tumor ≥1cm in diameter,40 hepatic VX2 tumor models were randomly divided into 2 groups for single radiation dose of 10Gy and 20 Gy respectively.MR-DWI scanning was performed was calculated at different time points,one day,5 days,10 days,15 days respectively after radiation therapy.ADC values were measured by choosing the ROI of the VX2 tumor tissue and normal liver tissue respectively,and then the ADC ratio of tumor tissue and normal liver tissue was calculated.The apoptotic index of specimen was calculated by DNA Nick end labeling (TUNEL)method,and statistical analysis was performed.Results:Fourty rabbit models of he-patic VX2 tumors were implated successfully and 48 lesions were detected.One day and 15 days after radiotherapy,these was no significant difference of ADC ratio and apoptotic index between 10Gy and 20Gy group (P>0.05),while 5 days and 15 days after radiotherapy,these was significant difference of ADC ratio and apoptotic index between 10Gy and 20Gy group (P<0.05).Conclusion:MR-DWI may help to reflect the dynamic changes of the molecular level at different time points for hepatic VX2 tumors after radiotherapy.The appropriate increased radiation dose could increased apoptosis,cell necrosis and disintegration could be more thorough,but it may increase radiation injury.