利用X射线相衬CT技术观察胆管结扎诱导肝纤维化微脉管的变化

摘要

目的 肝纤维化是慢性肝病向肝硬化发展的必然病理过程,本研究拟探讨X射线相衬CT (PCCT)技术评估胆管结扎诱导肝纤维化中微脉管变化的价值.材料与方法 胆管结扎诱导大鼠肝纤维化组和对照组肝脏组织各5例,成像实验在上海同步辐射装置的BL13W1线站进行,成像后样品进行天狼星红染色和CK19免疫组织化学染色.实验利用PCCT技术重建肝脏组织中的三维(3D)微脉管结构,并分析微脉管密度与纤维面积比之间的相关性.结果P CCT技术清晰地展示了肝脏中的血管、扩张胆管和增生胆管等脉管结构.与对照组相比,肝纤维化组3D微脉管密度和纤维面积比均明显增大(P＜0.0l),并且两者呈正相关(r=0.812,P＜0.01).结论 PCCT成像能够清晰展示肝纤维化组织微脉管结构的3D特征,并且3D微脉管密度与纤维面积比具有高度相关性,表明在肝纤维化发展中,微脉管的变化与纤维化程度密切相关,这为利用微脉管的变化评价纤维化疾病的发展提供了一种新思路.%Purpose Liver fibrosis is the common pathological process of cirrhosis developed by chronic liver disease.This study aims to explore the application of microvascular change in assessing the liver fibrosis induced by bile duct ligation based on X-ray phasecontrast computed tomography (PCCT).Materials and Methods Ten rats were equally divided into the group of bile duct ligation-induced liver fibrosis and the control group at random.Then ten excised liver tissues were imaged at beamline BL13W1 of Shanghai Synchrotron Radiation Facility in China.After the imaging studies,the liver samples were stained with Sirius red and immunostained with antibodies against cytokeratin 19 (CK19).The microvasculature in livers was reconstructed via PCCT,and the correlation analysis on microvascular density and the proportion of fibrosis area was performed.Results The microvasculature including blood vessels,dilated bile ducts and ductular proliferation were clearly revealed by PCCT technology.Moreover,the 3D microvascular density and proportion of fibrosis area in the liver fibrosis group increased significantly compared with those in the control group (P＜0.01),and the correlation between them was obvious (r=0.812,P＜0.01).Conclusion Microvascular 3D characteristics of liver fibrosis are well demonstrated by PCCT,and 3D microvascular density is significantly correlated with the proportion of fibrosis area.Those findings indicate that microvascular change is closely related to the degree of liver fibrosis induced by bile duct ligation,and thus it provides a novel means to assess the severity of liver fibrosis through microvascular change.