肝硬化分子影像学研究中门静脉入路的选择

目的探索经大鼠肝脏门静脉实施骨髓间充质干细胞（MSC）输入的入路，并建立合理的经门脉介入给药动物模型。方法20只正常SD大鼠和20只肝硬化大鼠为实验动物模型。选择盲肠静脉、脾静脉，脾脏和肠系膜下静脉的适合穿刺点，分别实施门静脉DSA造影。确定合适的门静脉DSA造影入路，建立门脉介入给药动物模型。结果通过各入路的DSA比较表明，盲肠静脉作为入路，DSA下可以清晰显示门静脉，穿刺成功率100％，大鼠门脉给药动物模型存活均72h。结论经盲肠静脉入路进行肝脏给药安全、可行，为肝脏MSC移植的分子影像学研究提供了合适的入路。     

近似人病理生理过程动物脂肪肝模型的综合建立方法

Objective To establish animal model of fatty liver similar with human pathophysiology used for the study of imaging quantitative diagnosis or verification of medicine curative effect. Methods Forty-five New Zealand white rabbits were used in this study. They were divided randomly into five groups : 10 rabbits in normal control group, 10 rabbits in experiment group 1,10 rabbits in experiment group 2,10 rabbits in experi-ment group 3,and remaining 5 rabbits were in a supplement group. Rabbits in normal control group were given free access to normal food and water for 9 weeks. Rabbits in the experimental groups were fed a high-fat and high-sucrose diet for 3,6,and 12 weeks,respectively. Rabbits in the supplement group were fed the same diet as the experimental groups. Liver specimen stained with HE and Sudan Ⅳ was examined histological. Results The success rate of hepatic steatotie models was 87 % (39 of 45 ) ;mortality was 13 % (6 of 45 ). There were 10 nor-mal livers, 10 mildly fatty livers, 9 moderately fatty livers, and 10 severely fatty livers in results (stained with HE), and the rate of conforming to Sudan Ⅳ was 75%. Conclusion The animal model of fatty liver with differ-ent severity can be established by being fed a high fat, high sucrose and alcohol diet.     

7.0T磁共振关节软骨T2弛豫时间图与量化分析的实验研究

目的建立超高场强磁共振关节软骨T2弛豫时间图成像技术和量化分析方法。方法用7.0T微磁共振机,采用多回波SE序列对琼脂糖凝胶体模和家猪髌骨扫描,获得T2加权图像,测定体模与髌骨软骨的信噪比。重构T2弛豫时间图,人工画感兴趣区测量T2值。结果琼脂糖凝胶体模和家猪髌骨T2加权图像清晰,对比度好,无异常伪影,信噪比高,重复性好。琼脂糖凝胶体模的T2值随浓度降低而增加。髌骨软骨呈分层状表现,软骨表层T2值高于中间层、深层、钙化层和软骨全层,差异具有统计学意义（P〈0.05）。结论T2弛豫时间图可量化测定关节软骨,是可行的、敏感的、特异的软骨分子成像技术。     

干细胞移植改善股骨头坏死缺血状态的实验及临床效应：20只模型兔及188例患者资料分析

背景：缺血性股骨头坏死由于股骨头局部滋养血管损伤、供血不足致病，迄今尚无最佳治疗方案，改善股骨头血液供应成为治疗本病的关键。 目的：通过动物实验和临床观察，验证自体骨髓问充质干细胞移植血管再生技术改善股骨头坏死缺血状态的效果。 设计：对比动物实验和自身对照临床观察。 单位：解放军第四六三医院细胞治疗中心。 资料：①动物：选用日本大耳白兔20只，雌雄不拘，体质量3．0—4．0kg，购于沈阳军区总医院动物实验中心。此动物实验符合动物伦理学要求。②对象：选择2004—07／2007—07在解放军第四六三医院细胞治疗中心住院的具有完整随访资料的缺血性股骨头坏死患者188例（335髋），男113例，女75例，年龄18-72岁。均经髋关节X线摄片、核素扫描、MRI、CT检查确诊；对治疗和实验知情同意。实验经医院伦理委员会批准。 方法：①动物实验：实验于2004—01／2004—06在沈阳军区总医院动物实验中心完成。采用液氮冷冻股骨头缺血性坏死模型建立方法，双后肢股骨头均制作缺血模型，右侧为移植组，左侧为对照组。抽取骨髓，将所获单个核细胞经右股动脉注入；同法将生理盐水注入左侧股动脉内。②临床观察：密度梯度离心缺血性股骨头坏死患者自体骨髓，分离单个核细胞。行旋股内、旋股外及闭孔动脉干细胞移植术。 主要观察指标：①4周后行DSA动脉造影观察双侧血管新生情况。4，12周后取双侧股骨头标本，行病理切片观察新骨再生及股骨头修复程度。②于移植后第3，6，12，24个月观察患者髋关节疼痛、行走间距及步态、髋关节外展与内旋功能变化。于干细胞移植后6个月行股骨头供血动脉造影术，观察血管新生及股骨头供血动脉充盈情况。于干细胞移植后6，12，24个月行CT，X射线，MRI检查，观察股骨?     

近似人病理生理过程动物脂肪肝模型的综合建立方法

Objective To establish animal model of fatty liver similar with human pathophysiology used for the study of imaging quantitative diagnosis or verification of medicine curative effect. Methods Forty-five New Zealand white rabbits were used in this study. They were divided randomly into five groups : 10 rabbits in normal control group, 10 rabbits in experiment group 1,10 rabbits in experiment group 2,10 rabbits in experi-ment group 3,and remaining 5 rabbits were in a supplement group. Rabbits in normal control group were given free access to normal food and water for 9 weeks. Rabbits in the experimental groups were fed a high-fat and high-sucrose diet for 3,6,and 12 weeks,respectively. Rabbits in the supplement group were fed the same diet as the experimental groups. Liver specimen stained with HE and Sudan Ⅳ was examined histological. Results The success rate of hepatic steatotie models was 87 % (39 of 45 ) ;mortality was 13 % (6 of 45 ). There were 10 nor-mal livers, 10 mildly fatty livers, 9 moderately fatty livers, and 10 severely fatty livers in results (stained with HE), and the rate of conforming to Sudan Ⅳ was 75%. Conclusion The animal model of fatty liver with differ-ent severity can be established by being fed a high fat, high sucrose and alcohol diet.     

支气管动脉造影及灌注术在肺癌诊断和治疗中的应用

原发性支气管肺癌主要由支气管动脉供血,支气管动脉造影可帮助肺内肿块定位和定性,评价肿块手术切除的可能性;另一方面,抗癌药物必须在癌细胞内达到一定浓度并维持一定的时间才能发挥疗效。经支气管动脉内灌注化疗可提高局部肿瘤内的抗癌剂浓     

肝移植后局限性肝实质并发症的影像学诊断进展

肝移植后肝实质并发症有弥漫性和局限性之分,其中局限性肝实质并发症可分为缺血性梗死、肝内血肿、肝脓肿、原发肿瘤复发、新生肿瘤、胆汁瘤和其他少见局限性并发症.由于肝移植术后并发症的临床表现常缺乏特异性且多变,因此,影像学对于术后并发症的早期诊断起着至关重要的作用~([1]).     

肝移植术后多发动脉狭窄的介入治疗一例

患者为男性,23岁,因急性肝功能衰竭、肝昏迷于2010年11月在外院行原位肝移植,术后第3天,丙氨酸转氨酶为337 U/L,天冬氨酸转氨酶为103 U/L,白蛋白为43.1 g/L,胆红素总量为101 μmol/L,直接胆红素为82μmol/L.行320排CT扫描检查,提示腹腔干起始部狭窄,达85%,肝右动脉起始部狭窄,达80%.腹腔动脉造影结果同上,肝动脉吻合口无明显狭窄.     

介入治疗异位妊娠的技术规范与发展

由于超声和人绒毛膜促性腺激素(ｈＣＧ)值测定此这2种技术的推广应用,临床上越来越多的异位妊娠病例可得到早期诊断,从而选择非手术治疗方法,介入治疗技术在这一领域的发展更是极大地丰富了这类疾病的治疗方法。如何正确地认识介入技术在异位妊娠治疗中的地位,以及合理地规范异位妊娠介入治疗中的操作技术是目前所面临的课题。1.适应证范围与治疗时机:异位妊娠的介入治疗技术包括2种,即经阴道输卵管胚囊内注射(ＩＧＳＩ,ｉｎｔｒａｇｅｓｔａｔｉｏｎａｌＳＡＣｉｎｊｅｃｔｉｏｎ)和经子宫动脉内插管灌注术(ＩＵＡＩ,ｉｎｔｒａｕｔｅｒｉ…     

肝移植术后移植肝血流灌注异常的CT灌注研究

目的 运用CT灌注成像(CTP)探讨肝移植术后肝脏血流灌注的影响因素.方法33例肝移植术后患者接受CT血管成像(CTA)及CTP检查.计算主动脉强化峰值的95%可信区间范围,排除此范围以外的病例.测量无并发症患者肝动脉灌注量(HAP)、门静脉灌注最(PVP)、总肝灌注最(TLP)及肝动脉灌注指数(HPI)的平均值及其95%可信区间范围,并在此基础上分析有术后并发症患者的肝脏血流灌注情况及上述各项指标的影响因素.结果29例患者纳入该研究,其中无术后并发症15例,有术后并发症14例.无术后并发症患者HAP、PVP、TLP和HPI的95%可信区间范围分别为(0.1509～0.3183)、(0.7223～1.3859)、(0.8367～1.7231)ml·min-1·ml-1和17.83%～31.63%.14例有并发症的患者中,HAP降低7例,其巾肝动脉狭窄5例、脾大3例;HAP增高2例,均为中、重度门静脉狭窄患者.PVP减低13例,其中门静脉狭窄或闭塞8例、脾肾分流4例、脂肪肝2例;TLP减低12例,全部与PVP减低有关.仅2例HAP减低患者HPI减低.结论CTP技术通过定量测量肝动脉、门静脉血流灌注,能够无创性评价各种移植肝血流灌注异常,客观评价移植肝缺血的程度和类型,对指导临床治疗具有重要价值.