Medical Image Monitoring Of Rabbit PVTT Biological Behavior And TACE Treatment Effect

PART â…  MDCT and DSA Study of Rabbit Model of Portal Vein Tumor ThrombusPurpose1. To establish an animal model of portal vein tumor thrombus.2. To investigate the value of MDCT and DSA on monitoring rabbit model of PVTT and analyze the influencing factors of establishing PVTT.Method and materials90 New Zealand rabbits were randomly divided into 3 groups,including group 1(60 animals)with tumor strip (1.5×0.05× 0.03cm)injected into portal vein,group 2(20 animals) with tumor piece (3xlxlmm) and group 3 (10 animals) with muscle strip (3×1×1mm), respectively. MDCT examinations at 1,3,7,14,21day were performed with plain scan, arterial phase and portal phase enhancement for all animals and 3D CT portography (3DCTP)were acquired. 1d after the last MDCT scan DSA portography were conducted. Pathological results of PVTT were obtained by macroscopic methods. The success rate of PVTT establishment in each group were analyzed statistically. The sensitivity and specifity of MDCT and DSA for depicting PVTT at different times were calculated.Results1. The success rate of PVTT in group 1 was 52.5 % significantly higher than that of 10% in group 2 (X²=9.76, P <0.01.2. At 7^th day, the positive rate of PVTT on 3D CTP, DSA and pathology were 60 % ,53.3%, 60%;The sensitivity and specificity for 3D CTP depiction of PVTT was 89.9% and 83.3%,respectively. The sensitivity and specificity for DSA depiction of PVTT was 89.9% and 100%. 3D CTP and DSA had no statistical difference in diagnosis of PVTT (X²=1.45, p>0.05).At 14^th day, the positive rate of PVTT on 3D CTP, DSA and pathology were 53.3%,46.7%, 46.7%;The sensitivity and specificity for 3D CTP depiction of PVTT was 100% and 89.9%,respectively. The sensitivity and specificity for DSA depiction of PVTT was 100% and 100%. 3DCTP and DSA had no statistical difference in diagnosis of PVTT (X2=1.45, p>0.05).At 21^th day, the positive rate of PVTT on 3D CTP, DSA and pathology were60%,50%, 50%; The sensitivity and specificity for CTP depiction of PVTT was 100% and 80.0%,respectively. The sensitivity and specificity for DSA depiction of PVTT was 100% and 100%. 3D CTP and DSA had no statistical difference in diagnosis of PVTT (X²=1.32, p>0.05).3. PVTT can be depicted by MDCT and DSA on the 7^th day. Cut-off sign was the definite diagnosis standard for PVTT by DSA and MDCT.Conclusion1. Injecting VX2 tumor strip into rabbit portal vein is a reliable method in establishing PVTT animal model with a 52.2% success rate.2. 3D CTP and DSA have the same value on depicting rabbit PVTT.Part â…¡ Biological Behaviour of Rabbit PVTT and its Blood Supply Analysis by MDCT Perfusion and DSAPurposeTo investigate the biological behavior of rabbit PVTT and its blood supply.Method and materials1. 50 New Zealand animals were divided into 2 groups including group1(40 animals) with tumor strip injected into main portal vein and group2 (10 animals)with tumor piece injected. MDCT examinations at different times were performed with plain scan,arterial and portal phase enhancement for all animals and 3D CT portography were acquired. Rabbits with PVTT had MDCT perfusion and HPI and PPI were measured by using a CT perfusion software. The CT value and maximal transverse diameter were measured on arterial and portal phase image.2. Hepatic arterial and portal angiography were performed for PVTT animals with DSA.3. Animals were killed at 7^th,14^th and 21th day and PVTTs were analyzed by HE stain.Results1. In group1,9 animals on 7^th day,7animals on 14^th day and 5 on the 21th day had PVTT. No positive results were found in group 2.2. PVTT were not depicted on axial enhanced MDCT image on the 7^th day. The mean maximal transverse diameter of PVTT on the 14^th day and 21th day were0.6±0.31cm and 1.1±0.2cm,and mean CT value on arterial and portal phase image were 127±13 and 119±15HU, 75±11 and 71±12HU.3. On 14^th day and 21^th day, the HAI and PPI of PVTT had statistically significant difference (0.70±0.06 VS 0.31±0.08, 0.65±0.05 VS 0.42±0.07, p<0.05);HPI of PVTT were significantly higher than liver parenchyma (0.70±0.06 VS 0.28±0.05, 0.65±0.05 VS 0.29±0.05, p<0.05) .4. The microscopic pathology showed that PVTT growed in the portal vein lumen with tumor cells adhesive to endothelial layer. After 14^th day PVTT growed into the wall of portai vein invasively.Conclusion1. PVTT get its nourishment and oxygen supply from portal blood at early stage and fed by arterial blood when invasion into the vessel wall.2. MDCT perfusion is a valuable method for analyzing blood supply of PVTT. PART â…¢ Effect and Safety of TACE for Rabbits with PVTTPurposeTo evaluate the effect and safety of treating PVTT Rabbits by TACE.Method and materials13 New Zealand rabbits with PVTT were divided into 2 groups, with 7 animals ingroup 1 for TACE ; 6 animals in group2 for saline infusion through common hepaticartery. MDCT examinations of plain scan, arterial and portal phase enhancement wereperformed at different times after TACE on a MDCT scanner . Treated animalsunderwent CT perfusion and HBV,HAP and HPP of PVTT,normal liver parenchemaand diseased liver lobe with PVTT were analyzed. Serum ALT and TB level weremeasured 1d before treatment and 7d after treatment. Hepatic artery and portal veinangiography were performed before animal sacrifice. Pathological study was madeunder microscope by HE stains.Results1. The average maximal transverse diameter of PVTT in treatment group was lessthan that of controls (1.15±0.1cm VS 0.55±0.09cm, p<0.05).2. The 1^st day after TACE Serum ALT and TB level were higher than that before treatment(195±9U VS 82±13U,5.9±0.76 VS 1.78±0.26 μmol/L p<0.05).On the 7^th day, the Serum ALT and TB decreased to normal level.3. HBV of PVTT deceased significantly(13.05±0.87 VS 26.03±3.67 ml·100mg^-1·min^-1, p<0.05)compared with that before TACE. The diseased liver with PVTT had HBV loss compared with that of normal parenchyma.4. Embolized PVTT and liver parenchyma had obvious coagulation necrosis .Conclusion1. TACE can inhibit the growth of rabbit PVTT.2. TACE is a safe method for treating PVTT when liver had good function compensation.3. MDCT perfusion is an useful measures in evaluating the effect of TACE on the treatment of PVTT.