CAJ | 학술논문

目的：利用磁共振灌注加权成像（PWI）评价无水乙醇消融治疗兔软组织VX2肿瘤的疗效。方法15只新西兰大白兔，雌雄不限，体重2.5～3 kg，在其右侧大腿内侧注射VX2肿瘤组织悬浮液各约0.2 ml，制备成荷瘤兔，于肿瘤组织接种后第14天行常规磁共振扫描，再经耳缘静脉注入Gd-DTPA（0.2 ml/kg），注射流率为1.5 ml/s。行GRE-EPI序列的T2*MR灌注扫描，扫描后第2天在磁共振导引及监视下行无水乙醇瘤内注射消融治疗。消融治疗后分别于第7、10天再行常规磁共振扫描及PWI扫描，扫描参数与术前一致。观察术前与术后肿瘤信号特点的变化，术前肿瘤实质与正常肌肉组织时间信号曲线的变化；灌注参数值：负性增强分数（NEI）和最大下降斜率（MSD）的对比；术后第7天、10天肿瘤中心灭活组织与术前肿瘤实质时间信号曲线的对比；灌注参数值的对比。及术前术后肿瘤病理特征的对比。结果术前肿瘤组织T1 WI呈等信号或稍低信号，T2 WI呈明显的高信号，时间信号曲线图（TIC）显示肿瘤组织的信号强度在对比剂首过时迅速降低。正常肌肉组织的TIC则变化较平缓。PEI术后第7、10天，肿瘤中心的灭活组织的TIC显示信号强度在对比剂首过时缓慢降低，但比正常肌肉组织下降明显。术前肿瘤组织的NEI及MSD（1145.53±69.79，536.69±17.69）较正常肌肉（763.26±72.57，355.24±25.58）大（P＜0.05），术后7 d、10 d肿瘤中心灭活组织的NEI及MSD较术前均降低，差异有统计学意义（P＜0.05）。结论磁共振PWI用来评价无水乙醇消融治疗兔软组织VX2肿瘤的疗效有意义，治疗早期肿瘤实质的灌注参数就出现变化。
목적：이용자공진관주가권성상（PWI）평개무수을순소융치료토연조직VX2종류적료효。방법15지신서란대백토，자웅불한，체중2.5～3 kg，재기우측대퇴내측주사VX2종류조직현부액각약0.2 ml，제비성하류토，우종류조직접충후제14천행상규자공진소묘，재경이연정맥주입Gd-DTPA（0.2 ml/kg），주사류솔위1.5 ml/s。행GRE-EPI서렬적T2*MR관주소묘，소묘후제2천재자공진도인급감시하행무수을순류내주사소융치료。소융치료후분별우제7、10천재행상규자공진소묘급PWI소묘，소묘삼수여술전일치。관찰술전여술후종류신호특점적변화，술전종류실질여정상기육조직시간신호곡선적변화；관주삼수치：부성증강분수（NEI）화최대하강사솔（MSD）적대비；술후제7천、10천종류중심멸활조직여술전종류실질시간신호곡선적대비；관주삼수치적대비。급술전술후종류병리특정적대비。결과술전종류조직T1 WI정등신호혹초저신호，T2 WI정명현적고신호，시간신호곡선도（TIC）현시종류조직적신호강도재대비제수과시신속강저。정상기육조직적TIC칙변화교평완。PEI술후제7、10천，종류중심적멸활조직적TIC현시신호강도재대비제수과시완만강저，단비정상기육조직하강명현。술전종류조직적NEI급MSD（1145.53±69.79，536.69±17.69）교정상기육（763.26±72.57，355.24±25.58）대（P＜0.05），술후7 d、10 d종류중심멸활조직적NEI급MSD교술전균강저，차이유통계학의의（P＜0.05）。결론자공진PWI용래평개무수을순소융치료토연조직VX2종류적료효유의의，치료조기종류실질적관주삼수취출현변화。
Objective To assess the therapeutic value of percutaneous ethanol ablation of VX2 soft tissue tumors in rabbits with T2*perfusion-weighted imaging(PWI).Methods 0.2 ml of tumor tissue suspensions were injected into the right medial thighs of 15 healthy New Zealand white rabbits.Conventional MRI and PWI was performed 2 weeks later with 0.2 ml/kg of GD-DTPA injected into the marginal veins of the rabbits' ears at the rate of 1.5 ml/s.3.5 mL of ethanol were injected percutaneously into the tumors under MRI guidance on the following day.Conventional MRI and PWI was repeated after 7 and 10 days.The pre-and post-ablation tumor signal characteristics,time intensity curves(TIC),negative enhancement integrals(NEI),and maximum slopes of decrease(MSD) of tumors and normal muscles were compared.Results MRI showed low T1 and high T2 signals of the tumors before ablation.The tumor TIC showed rapid signal intensity decrease in the first phase whereas the normal muscle TIC were flat at 7 and 10 days after ablation.The tumor NEI(1145.53±69.79)and MSD(1145.53±17.69)were significantly larger(P<0.05)than that of normal muscles (763.26±72.57,763.26±25.58)whereas the NEI and MSD of tumors were significantly lower at both 7 and 10 days after than that before ablation(P<0.05).Conclusion T2*PWI is useful for assessing the therapeutic value of percutaneous ethanol ablation in VX2 soft tissue tumors of rabbits.The perfusion parameters change soon after treatment.