大鼠肝硬化肝癌SPIO增强MRI表现与Kupffer细胞的关系

目的：建立二乙基亚硝胺（DENA）诱导的大鼠肝硬化肝细胞癌（HCC）模型，探讨超顺磁性氧化铁（SPIO）增强MRI上肝硬化肝癌信号改变与肝Kupffer细胞（KCs）之间的关系。方法：22只大鼠肝硬化肝癌模型，其中6只为单纯性肝硬化，16只为肝硬化肝癌，对照组为10只清洁级Wistar雄性大白鼠，均行SPIO增强前后T1WI和T2WI扫描，并行病理检查（HE染色及普鲁士蓝染色），分析肝脏Kupffer细胞数量与SPIO增强后信号之间的关系。结果：普鲁士兰染色切片上肝硬化组织内蓝染Kupffer细胞数量略减少，蓝色颗粒不均匀；高分化肝癌中Kupffer细胞减少，低分化肝癌Kupffer细胞显著减少甚至消失。肝癌与正常肝实质、硬化肝组织相比，Kupffer细胞数量减少，差异有显著性意义（P〈0．001）；正常肝实质与肝硬化组织内Kupffer细胞数量的差异无显著性意义（P＝0．088）。SPIO增强T2WI上，正常肝实质、肝硬化组织信号强度（SI）较增强前明显下降，信号强度下降百分比（PSIL）分别为42％和38％，两组间差异无统计学意义（P＝0．409）；肝癌信号强度较增强前无明显下降，PSIL为12％，明显低于正常肝实质和肝硬化组织（P〈0．001）；SPIO增强后肝癌对比噪声比（CNR）较增强前显著提高（P＝0．002）。SPIO增强T1WI上。正常肝实质及硬化肝组织PSIL分别为15％和6％，而肝癌的信号强度较增强前升高9％，部分小病灶呈不均匀轻度强化，肝癌CNR较增强前明显降低（P〈0．001）。SPIO增强T2WI上，肝组织PSIL与Kupffer细胞数量呈曲线趋势，随着组织内Kupffer细胞数量的增多病灶信号强度下降程度越明显，曲线估计3次模型决定系数R^2为0．920，有显著性意义（P〈0．001）。结论：SPIO增强T2WI上肝脏信号强度改变与Kupffer细胞数量及其吞噬功能有相关性，随着Kupffer细胞增多PSIL呈升高趋势。SPIO增强MRI不?

SPIO-enhanced MR Imaging of the Rat with Cirrhosis and Hepatocellular Carcinoma:Relationship with Kupffer Cells of Liver

Objective:To establish the model of (DENA) induced hepatocellular carcinoma (HCC) and cirrhosis of rat and to study their signal intensity (SI) on superparamagnetic iron oxide (SPIO)-enhanced MR images and the relationship with the amount of Kupffer cells (KCs).Methods:Twenty-two rats with DENA induced HCC and cirrhosis were studied,including simple cirrhosis (6 rats) and HCC associated with cirrhosis (16 rats).Ten normal wistar male rats served as the control group.MRI (T1WI,T2WI) before and after SPIO enh...