本文選題：計(jì)算機(jī)體層成像 + 灌注加權(quán)成像　； 參考：《遼寧醫(yī)學(xué)院》2013年碩士論文

【摘要】：目的 通過多層螺旋CT灌注技術(shù)測得恩度治療前后兔門靜脈VX2癌栓CT各灌注參數(shù)值，與免疫組織化學(xué)方法獲得恩度治療前后兔門靜脈VX2癌栓VEGF表達(dá)結(jié)果作相關(guān)性研究，評價(jià)恩度對兔門靜脈VX2癌栓的抗血管生成作用。 方法 1、將復(fù)蘇后的VX2瘤株接種于1只日本大耳白兔腹股溝區(qū)肌肉內(nèi)傳代，14天后行MRI掃證實(shí)腫瘤傳代成功。取出傳代兔腹股溝區(qū)肌內(nèi)腫瘤制成瘤條，開腹手術(shù)方式將瘤條種植在18只實(shí)驗(yàn)兔門靜脈內(nèi)，2周后分別行GE Light speed16螺旋CT增強(qiáng)掃描證實(shí)腫瘤種植成功，之后將18只荷瘤的日本大耳白兔隨機(jī)分成恩度組、生理鹽水組、空白組，每組6只，各組治療前及治療2周后分別行GE Light speed16螺旋CT灌注掃描，獲得各組治療前、后CT灌注圖及灌注參數(shù)值：血流量（BF）、血容積（BV）、毛細(xì)血管表面通透性（PS）。 2、空白組實(shí)驗(yàn)兔于分組后即處死，恩度組及生理鹽水組實(shí)驗(yàn)兔治療2周后行CT灌注掃描后處死，留取移植瘤標(biāo)本，盡量與灌注層面保持一致，所有移植瘤組織經(jīng)10%Formalin固定，常規(guī)石蠟包埋，5μm連續(xù)切片，對移植瘤區(qū)域做：HE染色、免疫組化染色。免疫組化采用SP二步法，VEGF結(jié)果判定依據(jù)文獻(xiàn)所述方法進(jìn)行。最后將CT灌注參數(shù)與免疫組化VEGF表達(dá)結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果 各組均獲得滿意MSCT灌注圖像、灌注參數(shù)及VEGF表達(dá)圖像。 1、恩度組治療后較治療前門靜脈癌栓CT各灌注參數(shù)： BF、BV、PS均值均明顯降低(p 0.05)。恩度組治療后較生理鹽水組治療后門靜脈癌栓CT各灌注參數(shù)： BF、BV、PS均值均明顯降低(p 0.05)。 2、免疫組織化學(xué)檢測恩度治療后門靜脈癌栓VEGF表達(dá)結(jié)果較治療前明顯減低，差異有顯著統(tǒng)計(jì)學(xué)意義（p0.01）。 3、空白組、恩度組治療后、生理鹽水組治療后門靜脈癌栓CT灌注參數(shù)BV與PS呈高度正相關(guān)，相關(guān)系數(shù)r分別為0.895、0.903、0.873（p0.01） 4、空白組門靜脈癌栓各灌注參數(shù)與VEGF表達(dá)結(jié)果均呈高度正相關(guān)，r值分別為0.853、0.896、0.813（p0.01），生理鹽水組治療后門靜脈癌栓各灌注參數(shù)與VEGF表達(dá)結(jié)果均呈高度正相關(guān)，r值分別為0.861、0.892、0.814（p0.01）。恩度組治療后門靜脈癌栓各灌注參數(shù)與VEGF表達(dá)結(jié)果均呈高度正相關(guān)，r值分別為0.863、0.828、0.837（p0.01）。 結(jié)論 1、恩度作為一種靶向抗VEGF的藥物，作用于門靜脈癌栓組織后使門靜脈癌栓組織中VEGF的表達(dá)程度降低。 2、MSCT灌注成像能獲得并分析門靜脈癌栓灌注參數(shù)（BF、BV、PS），可以間接了解門靜脈癌栓的VEGF表達(dá)程度，進(jìn)而明確腫瘤內(nèi)血管生成情況，，對指導(dǎo)門靜脈癌栓的治療療效的評價(jià)有一定的價(jià)值。
[Abstract]:Purpose The CT perfusion parameters of VX2 tumor thrombus in portal vein of rabbits were measured by multi-slice spiral CT perfusion technique before and after Endor treatment, and the correlation between CT perfusion parameters and VEGF expression of VX2 tumor thrombus in portal vein of rabbits before and after Endor therapy was studied by immunohistochemical method. To evaluate the anti-angiogenesis effect of Endor on portal vein VX2 tumor thrombus in rabbits. Method 1. The VX2 tumor strain after resuscitation was inoculated into the inguinal muscle of a Japanese white rabbit. The successful passage was confirmed by MRI scan 14 days later. The intramuscular tumors in the inguinal region of rabbits were taken out and made into tumor strips. The tumor strips were implanted in the portal vein of 18 rabbits by open surgery for 2 weeks. The tumor was successfully implanted by GE Light speed16 enhanced CT scan. After that, 18 Japanese large ear white rabbits were randomly divided into three groups: Endol group, normal saline group and blank group, 6 rabbits in each group. GE Light speed16 spiral CT perfusion scanning was performed before treatment and 2 weeks after treatment. Post CT perfusion imaging and perfusion parameters: blood flow volume, blood volume, capillary surface permeability. 2. The rabbits in the blank group were killed immediately after being divided into groups. The rabbits in the Endol group and the saline group were sacrificed after 2 weeks of CT perfusion scanning. The transplanted tumor specimens were collected and kept consistent with the perfusion level as far as possible. All the transplanted tumor tissues were fixed by 10%Formalin. Routine paraffin-embedded 5 渭 m serial sections were used to detect the transplanted tumor area with the use of w he staining and immunohistochemical staining. The SP two-step method was used to determine the VEGF results according to the method mentioned in the literature. Finally, CT perfusion parameters and immunohistochemical VEGF expression results were statistically analyzed. Result Satisfactory MSCT perfusion images, perfusion parameters and VEGF expression images were obtained in all groups. 1. The CT perfusion parameters of portal vein tumor thrombus after treatment in Endol group were significantly lower than those before treatment: the mean value of BVV / PS in BFU group was significantly lower than that in control group (P 0.05). The CT perfusion parameters of portal vein tumor thrombus after treatment in Endol group were significantly lower than those in saline group: the mean value of BFV / BV / PS was significantly lower than that in control group (P 0.05). 2. The expression of VEGF in portal vein tumor thrombus was significantly lower than that before treatment by immunohistochemistry, and the difference was statistically significant (P 0.01). (3) after treatment, the CT perfusion parameters (BV) of portal vein tumor thrombus were positively correlated with PS in normal saline group (r = 0.895). 4. There was a high positive correlation between the perfusion parameters of portal vein tumor thrombus and the expression of VEGF in the blank group. The values of the perfusion parameters and the expression of VEGF in the portal vein tumor thrombus were 0.853X 0.896U 0.813p0.01g, respectively. The positive correlation between the perfusion parameters of the portal vein tumor thrombus and the expression of VEGF in the saline group was 0.861U 0.8920.814p0.01a, respectively. There was a high positive correlation between the perfusion parameters of portal vein tumor thrombus and the expression of VEGF in the Endol group after treatment. Conclusion 1. Endol, as a targeted drug against VEGF, reduced the expression of VEGF in portal vein tumor thrombus after acting on portal vein tumor thrombus. 2MSCT perfusion imaging can obtain and analyze the perfusion parameters of portal vein tumor thrombus. It can indirectly understand the degree of VEGF expression in portal vein tumor thrombus, and then determine the angiogenesis in the tumor. It has certain value in guiding the evaluation of therapeutic effect of portal vein tumor thrombus.
【學(xué)位授予單位】：遼寧醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R735.7;R816.5

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