| ObjectiveTo establish an animal model similar to human s hepatocellular carcinoma ( HCC) , and study the hemodynamic changes in rabbit liver before and after VX2 liver tumor implanted by perfusion imaging of multisection CT ( MSCTP). To assess the feasiabilities and independent studies of perfusion imaging for cancer diagnosis. To evaluate the practical significances of perfusion imaging on physiological feature of HCC neogenesis vessels by compairing the MVD,VEGF with the perfusion parameters. To further investigate the clinical value of the quantitative MSCTP on the pathological and hemodynamic changes of HCC.Material and Method1. Animal experiment(1) The VX2 liver tumors were made in 20 rabbits and observed the changes of the biochemical markers ( ALT, AST and Tbil) continuously before and after VX2 liver tumors were inoculated. Within 21 days after inoculation , every other three days all rabbits underwent plain CT, perfusion CT and three - phases contrast CT. The perfusion parameters ,such as: HBF, HBV, MTT, PS, HAI, HAP and HPP were analysed by the Perfusion 3 software of GE 16 detector MSCT.(2) 16 rabbit - models were killed after CT perfusion and their livers wereembedded in paraffin , fixed in 10% Formalin and spitted continuously in 5μm - section. The enhanced border of tumors were examined pathologically with HE dying, immunohistochemistry of Power Vision?. The results of immunohisto-chemistry were compared with the perfusion parameters.2. Clinical study30 patients without any other liver diseases and malignant tumors in other organs were thought to be control groups, and 30 patients with HCC were experimental groups. All were performed by plain CT, perfusion CT and three - phases contrast CT. The perfusion parameters HBF, HBV, MTT,PS, HAI, HAP and HPP were divided into three groups: the cancer group, the adjacent liver surrounding the cancer group and the normal liver group.3. Statistical analysisAll the data were analysed by SPSS software. Quantitative data were shown by x ± s , T — test and ANOVA were applied. The correlation of parameters were analysed by Pearson s statistical methods, p <0. 05 were defined as threshold for statistical differences and p <0.01 were significant differences.Result1. The survival rate of the rabbits inoculated VX2 tumor was 100%. The values of ALT and AST in the animal' s serum did not change apparently on the 7 th day after inoculation and they began to change on the 14 th day after inoculation. The TBil wasn' t tested for hemolysis effect.2. Within 1-21 days after inoculation ,the values in the border of tumors were compared with those in non - tumorous regions. In the border of tumors , the parmeters such as HBF,HBV,HAP,PS increased while MTT and HPP de-screaed( p <0. 05). All these changes occurred at 5 -8 days after inoculation. Every perfusion parameter changed significantly with tumor growth ( p < 0.05) , but the perfusion parmeters in the non - tumorous areas did not changed with tumor growth (p >0.05).3. The tumors' neogenesis vessels were showed by positive CD34 at peri -tumor, but not expressed in normal hepatic tissues. There were significant differ-ences between the two regions(p <0.01).4. The positive rate of VEGF expression in centre and border of the tumor were 56% and 93% respectively. The differences between them were significant (p <0. 05). The positive signals were all in the cytoplasm and located in the center of tumor > the border of tumor and the liver surrounding it .5. The correlation analysis was done between the MVD and VEGF in the border of the tumor. There were significant differences beween them ( p < 0. 01). The more VEGF expressed, the more MVD increased.6. The correlation analysis was done between the perfusion parameters and MVD, VEGF in the border of the tumor. The positive relation were showed between the values of HBF, PS, HAI, HAP and MVD, VEGF, and the negative relation were showed by HPP and MVD, VEGF, and no relations between the values of MTT, HBV and MVD, VEGF.7. The decreased HBF, HBV and the increased HAP, HAI in the border of tumor differenciated from those in the area surrounding the tumor and normal liver region (p <0.05). The decreased MTT and PS had no significant differences . All the parameters beween the area surrounding the tumor and normal livers had no differences.Conclusion1. The VX2 liver tumor' s blood supply, changes of the liver functions, pathological appearances and patterns of CT were much alike the humans' and they can be used to study the hemodynamic changes of HCC.2. MSCTP has significant superiority and accuracy on observing the hemodynamic changes of the liver before and after the tumor implantation. MSCTP can analyse the blood supply of hepatic artery and portal vein quantitatively , and discover some physiological changes beyond the traditional CT. MSCTP can detect the tumor and distinguish the character of the lesion earlier, and evaluate the curative effect and the prognosis.3. There was significant correlation between the perfusion parmeters and MVD, VEGF. The perfusion parmeters can be used to evaluate tumor angiogene-... |
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