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目的评估CT灌注各参数早期预测索拉非尼治疗大鼠肝癌效果的可行性。方法 40只Wistar大鼠肝脏内种植大鼠肝癌后第9天行CT灌注成像扫描。肝癌最大径均值(0.57±0.34)cm。扫描后实验组(n=28)索拉非尼灌胃治疗,对照组相同剂量生理盐水灌胃。依据治疗21天后测量肿瘤最大径减少的大鼠为有效组,其他设定为无效组。在治疗前、治疗后第11天及第21天分别行CT灌注扫描。最后一次扫描后处死大鼠,取带有肿瘤组织的肝叶做免疫组织化学检查。对比分析三组灌注数据之间的差异,应用微血管密度(MVD)与灌注参数值的相关性。结果 CT灌注成像技术可以反映肝癌治疗前后血液动力学变化。在治疗后的第11天有效组的肝动脉灌注量(ALP)即出现显著下降(71.5 ml·min-1·100 ml-1降至53.4 ml·min-1·100 ml-1。而无效组(P=0.87)和对照组(P=0.34)无显著变化。治疗后21天,有效组肿瘤最大径显著缩小(P=0.042),对照组肿瘤最大径明显增加(P=0.001)。统计学表明大鼠肝癌的MVD与ALP有较好的相关性(r=0.647)。结论 CT灌注可以定量分析经索拉非尼治疗前后肝癌内的血流动力学变化;进而对索拉非尼的疗效进行早期预测。
Objective To evaluate the feasibility of early predicting the effect of sorafenib on rat liver cancer by CT perfusion parameters. Methods CT perfusion imaging was performed on the 9th day after implantation of rat liver cancer in the liver of 40 Wistar rats. The maximum diameter of liver cancer (0.57 ± 0.34) cm. After the test, the experimental group (n = 28) was treated with sorafenib and the control group with the same dose of saline. According to the treatment of 21 days after the measurement of the maximum diameter of the tumor reduction in the effective group, the other set to invalid group. CT perfusion scanning was performed before treatment, on the 11th and 21st days after treatment. After the last scan, the rats were sacrificed and the liver tissue with tumor tissue was taken for immunohistochemistry. The differences between perfusion data of three groups were compared and analyzed, and the correlation between perfusion parameters and microvessel density (MVD) was applied. Results CT perfusion imaging can reflect the hemodynamic changes of liver cancer before and after treatment. On day 11 after treatment, hepatic artery perfusion (ALP) of the effective group was significantly decreased (71.5 ml · min -1 · 100 ml -1 to 53.4 ml · min -1 · 100 ml -1. (P = 0.87) and the control group (P = 0.34) .There was no significant change in the maximum diameter of the tumor in the effective group (P = 0.042) and the largest diameter of the tumor in the control group (P = 0.001) The results showed that there was a good correlation between MVD and ALP in rat hepatocarcinoma (r = 0.647) .Conclusion CT perfusion can quantitatively analyze the hemodynamic changes in hepatocellular carcinoma before and after sorafenib treatment, and then the efficacy of sorafenib Make early predictions.