全肝 CT 灌注成像评估兔肝 VX2 瘤有效灌注及与 免疫组织化学对比分析

目的：分析兔VX2肝肿瘤模型的全肝CT灌注成像灌注参数与不成对动脉(unpaired arteries，UAs)、微血管 面积(microvessel area，MVA)免疫组织化学指标的相关性，以进一步了解兔VX2肝肿瘤血管生成状况及与灌注成像表 现的本质。方法：在术后2周对兔VX2肝肿瘤模型及假手术对照组兔行全肝CT灌注成像，获得兔VX2肝肿瘤组织、瘤 周肝组织及假手术组的肝灌注血流量(blood fl ow，BF)、肝灌注血容量(blood volume，BV)、肝动脉灌注量(arterial liver perfusion，ALP)、门静脉灌注量(portal liver perfusion，PVP)、肝动脉灌注指数(hepatic perfusion index，HPI)等参数，并 于检查完后通过免疫组织化学染色，获得肿瘤标本的UAs及MVA值。分析统计在有活力肿瘤边缘区(肝肿瘤组织)与瘤 周肝组织的各CT灌注参数值之间的差异，各参数值与兔VX2肝肿瘤内的代表肿瘤新生细动脉的病理免疫组织化学指 标UAs及代表血窦毛细血管化程度的MVA之间的关系。结果：实验组瘤组织与实验组瘤周肝组织和假手术组比较，全 肝CT灌注参数BF，BV，ALP，PVP，HPI差异均有统计学意义(P<0.05)。但实验组瘤周肝组织与假手术组比较，全肝 CT灌注参数BF，BV，ALP，PVP，HPI差异均无统计学意义(P>0.05)。免疫组织化学指标UAs与MVA呈正相关；肿瘤 组织的BF，ALP，BV与UAs及MVA呈正相关，而PVP与UAs及MVA呈负相关，HPI与UAs呈正相关，HPI与MVA无显著 相关。结论：全肝CT灌注可定量评估兔VX2肝肿瘤的肝动脉和门静脉灌注信息，并可在一定程度上反映肿瘤血管的 生成状况。

Total liver CT perfusion imaging for evaluation on rabbit liver VX2 tumor perfusion and comparative analysis through immunohistochemisty

Objective: To investigate the correlations among total liver CT perfusion parameters, unpaired arteries (UAs) and microvessel area (MVA) in a rabbit liver VX2 tumor model, and to learn the tumoral angiogenesis condition and the mechanisms for perfusion imaging. Methods: Rabbits with or without the inoculated VX2 tumor in the liver underwent total liver CT perfusion imaging 2 weeks after the operation. Perfusion parameters included blood flow (BF), blood volume (BV), arterial liver perfusion (ALP), portal liver perfusion (PVP), hepatic perfusion index (HPI) for the tumor rim and the surrounding liver tissue. After the examination, the UAs and MVA of tumor tissues were obtained by immunohistochemical staining. The differences of perfusion parameters between the vital tumor rim and the surrounding liver tissue were compared. The correlations among perfusion parameters, UAs and MVA were analyzed. Results: There was significant difference between the CT perfusion parameters at the tumor rim and the surrounding liver tissue or liver tissue of the control group (P<0.05), but there was no significant difference between the perfusion parameters at the surrounding liver tissues of the experimental group and the control (P>0.05). There was positive correlation between UAs and MVA. UAs and MVA were positively correlated with BF, ALP and BV at the tumor rim. UAs and MVA were negatively correlated with PVP. HPI positively correlated with UAs, but it was not correlated with MVA. Conclusion: Total liver CT perfusion can provide quantitative information to evaluate the artery and portal vein perfusion of liver VX2 tumor, and to assess the degree of tumor angiogenesis.