中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2009年
5期
486-489
,共4页
曲雅静%郑静晨%黎功%宁健%程海民%高建华%叶道斌%王海燕%李广欣%金帅%李韧
麯雅靜%鄭靜晨%黎功%寧健%程海民%高建華%葉道斌%王海燕%李廣訢%金帥%李韌
곡아정%정정신%려공%저건%정해민%고건화%협도빈%왕해연%리엄흔%금수%리인
放射性肝损伤%体层摄影术%X线计算机%生化指标%病理学
放射性肝損傷%體層攝影術%X線計算機%生化指標%病理學
방사성간손상%체층섭영술%X선계산궤%생화지표%병이학
Radiation-induced liver injury%Tomography%X-ray computation%Biochemical indicator%Pathology
目的 探讨放射性肝损伤的生化指标、CT影像及病理学特点.方法 20只新西兰白兔随机分为4组:对照组,半肝放疗10、15和20 Gy组,放疗后3个月内监测肝功能、凝血功能,放疗后第3个月观察肝脏CT影像及病理变化特点.结果 20 Gy组死亡3只,余组无死亡;10和15 Gy组谷草转氨酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)于放疗后1个月起明显升高,碱性磷酸酶(ALP)放疗后下降,纤维蛋白原(FbgC)、凝血酶时间(TT)于放疗后1周升高显著,2周恢复至正常;CT增强扫描动脉期无强化,静脉期全肝广泛强化,肝内静脉显影不清,延迟期造影剂消退快;病理表现为随放疗剂量加大,肝静脉闭塞征、肝纤维化和胆管损伤表现越明显,同一放疗后肝脏照射区损伤较非照射区略重.结论 半肝放疗20 Gy死亡率明显增高,10和15 Gy后可引起肝功能改变及凝血功能一过性改变;CT表现为增强扫描显示强化减弱,肝静脉显影不清;随放疗剂量加大放射性肝纤维化、肝静脉闭塞征等表现加重.
目的 探討放射性肝損傷的生化指標、CT影像及病理學特點.方法 20隻新西蘭白兔隨機分為4組:對照組,半肝放療10、15和20 Gy組,放療後3箇月內鑑測肝功能、凝血功能,放療後第3箇月觀察肝髒CT影像及病理變化特點.結果 20 Gy組死亡3隻,餘組無死亡;10和15 Gy組穀草轉氨酶(AST)、總膽紅素(TBIL)、直接膽紅素(DBIL)于放療後1箇月起明顯升高,堿性燐痠酶(ALP)放療後下降,纖維蛋白原(FbgC)、凝血酶時間(TT)于放療後1週升高顯著,2週恢複至正常;CT增彊掃描動脈期無彊化,靜脈期全肝廣汎彊化,肝內靜脈顯影不清,延遲期造影劑消退快;病理錶現為隨放療劑量加大,肝靜脈閉塞徵、肝纖維化和膽管損傷錶現越明顯,同一放療後肝髒照射區損傷較非照射區略重.結論 半肝放療20 Gy死亡率明顯增高,10和15 Gy後可引起肝功能改變及凝血功能一過性改變;CT錶現為增彊掃描顯示彊化減弱,肝靜脈顯影不清;隨放療劑量加大放射性肝纖維化、肝靜脈閉塞徵等錶現加重.
목적 탐토방사성간손상적생화지표、CT영상급병이학특점.방법 20지신서란백토수궤분위4조:대조조,반간방료10、15화20 Gy조,방료후3개월내감측간공능、응혈공능,방료후제3개월관찰간장CT영상급병리변화특점.결과 20 Gy조사망3지,여조무사망;10화15 Gy조곡초전안매(AST)、총담홍소(TBIL)、직접담홍소(DBIL)우방료후1개월기명현승고,감성린산매(ALP)방료후하강,섬유단백원(FbgC)、응혈매시간(TT)우방료후1주승고현저,2주회복지정상;CT증강소묘동맥기무강화,정맥기전간엄범강화,간내정맥현영불청,연지기조영제소퇴쾌;병리표현위수방료제량가대,간정맥폐새정、간섬유화화담관손상표현월명현,동일방료후간장조사구손상교비조사구략중.결론 반간방료20 Gy사망솔명현증고,10화15 Gy후가인기간공능개변급응혈공능일과성개변;CT표현위증강소묘현시강화감약,간정맥현영불청;수방료제량가대방사성간섬유화、간정맥폐새정등표현가중.
Objective To explore the appearance of radiation induced liver disease (RILD) on biochemical indicator,computer tomography (CT) and pathology.Methods Twenty rabbits were randomly divided into 4 groups as control group,10,15 and 20 Gy groups administered with semi-liver radiotherapy at different doses.Hepatic function and blood coagulation function indicators were monitored for 3 months after radiation.The appearance of CT images and pathology were observed 3 months post irradiation.Results After irradiation,20 Gy group had 3 rabbits died(3/5),while the other groups had no death.AST,TBIL and DBIL of groups B and C were increased at 1 month post irradiation,while ALP decreased.FbgC and Tr were increased at 1 week post irradiation,then decreased to the normal level at 2 week.The CT image appearances were similar among 4 groups,including no enhancement in artery phase,enhancement of whole liver in portal phase,the veins of liver unclear,and little enhancement in prolonged phase.The pathologic bases of RILD were VOD,collagen fiber aggradation and bile duct inflammation.The changes above-mentioned were more obvious when the radiation dose increased.Conclusions The death rate goes up apparently at the dose of 20 Gy for semi-liver radiotherapy.The doses of 10 and 15 Gy could induce hypohepatia and blood coagulation function to temporarily change.Appearances of CT are weakly enhanced and the veins of liver unclear.When the radiation dose increases,VOD and liver fibrosis become more serious.
