摘要目的 评价64排CT及CT血管成像(CTA)对兔VX2肝癌移植瘤灶的诊断价值.方法 40只新西兰大白兔采用CT引导下经皮穿刺瘤组织块种植法成功建立兔VX2肝癌模型38只,于种植后第14、21、28天行CT扫描并血管成像,随后行数字减影血管造影(DSA).结果 (1)CT显示种植后第14、21、28天移植瘤大小分别为(0.7±0.5)、(5.3±3.1)、(16.0±7.5) cm3,差异均有统计学意义(均P＜0.05),所有瘤灶在CT增强扫描动脉期均明显强化,静脉期、延迟期强化退出,平扫、动脉期、门脉期、延迟期的CT值,第14天分别为(50.0±3.2)、(114.8±3.2)、(89.0±2.9)、(62.2±3.1) HU,第21天分别为(47.1±2.6)、(195.9±7.3)、(164.1±6.4)、(103.2±3.5) HU,第28天分别为(48.4±2.5)、(204.6±8.9)、(155.3±6.5)、(101.3士3.8)HU,3期CT值差异均有统计学意义(均P ＜0.01).(2) CTA显示移植瘤供血动脉为肝动脉.(3) CTA与DSA在移植瘤供血动脉的显示率分别为76.3％、78.9％(第21天)与84.2％、89.5％(第28天),差异无统计学意义(P＞0.05).结论 兔VX2肝移植瘤为富血供肿瘤,CT增强扫描能动态监测移植瘤生长情况,而CTA能较好显示其供血动脉,在兔VX2肝移植瘤的介入术前评估、术后评价方面基本能取代DSA检查.

abstractsObjective To evaluate the diagnostic values of computed tomographic angiography (CTA) for liver VX2 tumor in rabbits.Methods A total of 40 New Zealand white rabbits were employed by implanting tumor fragment into left liver by computed tomography (CT)-guided percutaneous puncture.And successful modeling was established in 38 rabbits.Plain and three-phase enhanced CT scan and its CTA reconstruction were performed in different stages (14,21 and 28 days) after tumor implantation,followed by digital subtraction angiography (DSA) via femoral artery and hepatic artery.Dynamic observations of tumor growth characteristics were recorded by plain and enhanced CT and comparing CTA and DSA images.And comparisons of CTA and DSA were made for identifying the origin,course and blood supply of transplanted tumors.Results (1) Multi-slice computed tomography (MSCT) could dynamically monitor the growth transfer characteristics.And all tumors became strengthened obviously in arterial phase and washed out in venous and delayed phases.(2) CTA showed that the feeding artery of transplanted tumor was hepatic artery.(3) No obvious differences existed in the display of feeding artery of transplanted tumor between CTA and DSA.However CTA was superior to DSA in displaying three-dimensional structure.Conclusion Liver VX2 tumors are hypervascular in rabbits.CT enhanced scanning may dynamically monitor the growth patterns of tumors and CTA is a better method than DSA in visualizing the feeding arteries of tumors.Before and after interventions,CTA may replace DSA in evaluating liver VX2 tumors in rabbits.