| Objective:To study characteristics and diagnosing values of diffusion-weighted imaging(DWI) in SD rat models of liver cirrhosis, hepatocellular carcinoma(HCC) and HCC treated with high intensity focused ultrasound (HIFU).MaterMethods:128SD rats were dealed with diethylnitrosamine (DEN)0.02g/kg three times weekly to establish liver cirrhosis and cancer model. Rats were tested by abdominal ultrasound, as well as liver biopsy regularly. If the liver cancer is greater than1cm, confirmed by ultrasound image and pathology, the rats were treated with HIFU.Rats were examined with DWI and liver biopsy at0,8±1,12±1,14±th week respectively. Except these regular tests, specimens were collected for proteomics study pre and post HIFU treatment.Dynamic analysis of image features in40rats with hepatocellular carcinoma and23cases of HIFU treatment model. ADC values were analyzed by one-way ANOVA, paired T test, or non-parametric test.Results:82rats survived after14weeks,72of them (87.8%) developed liver cancer (tumor diameter:1.2±0.5cm).47rats with liver tumor were treated with HIFU,23of them completed the HIFU treatment and got fully DWI and pathological data. Pathology results confirmed that rat liver developed early, advanced cirrhosis, and hepatocellular carcinoma(HCC) at8±1,12±1,14±th week respectively.Signal in normal liver cirrhosis was usual; signal was slightly high and uneven in early cirrhosis; signal was further high and uneven in advanced cirrhosis, displayed internal nodular.72HCC tumors showed high signal; signal at most big tumor was high and uneven; area of necrosis showed relatively low signal. When the b-value was50s/mm2, the ADC values in normal liver, early〠advanced cirrhosis and HCC were (2.65±0.37),(2.01±0.69),(1.68±0.21),(2.46±0.86)×10-3mm2/s respectively; the differences were significant (F=4.341, P<0.05). Multiple comparisons showed that the difference between advanced cirrhosis and HCC was significant; but the differences between normal and early cirrhosis, early cirrhosis and advanced cirrhosis were not significant (t=-2.82489, p<0.05; t=1.964409, P>0.05; t=1.619543, P>0.05). When the b value was100s/mm2, the ADC values in normal liver, early〠advanced cirrhosis and hepatocellular carcinoma were (2.51±0.32),(2.19±0.46),(1.71±0.42),(2.29±0.2)×10-3mm2/s, the ADC value changes displayed no significant difference (Friedman test, P>0.05).After HIFU treatment, the DWI signal was reduced significantly within coagulative necrosis region, the ADC value was increased; A few days later, tumors appeared atrophy, but residual tumor parts did not change obviously.When b=50,100s/mm2, the preoperative and postoperative ADC values were (2.20±0.78),(2.05±0.49) and (2.12±0.63),(1.89±0.55)×10-3mm2/s, the ADC value changes were not significant (t=0.35, P<0.05; Z=-0.88, P>0.05). Proteomic analysis showed that proliferation related protein (GTP-binding nuclear protein Ran,GTP-Ran) and invasion related protein (Triosephosphate and isomerase,TI)were decreased after HIFU treatment.Conclusion:The DWI displayed characteristics in cirrhosis and HIFU treatment of HCC. DWI has potential value in diagnosis of HCC and HIFU postoperative evaluation. |
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