MR-DWI对重组人血管内皮抑制素给药途径的评价

摘要

目的 应用磁共振扩散加权成像(MR-DWI)评价重组人血管内皮抑制素(recombinant human endostatin,ES)经动脉灌注给药与经静脉注射给药对兔VX2肝移植瘤的早期疗效.方法 采用开腹瘤块种植法建立兔VX2肝移植瘤模型,随机将其分为3组,每组8只.二维超声监测移植瘤生长情况,待肿瘤长到1 cm3左右时,分别对每组动物行相应干预处理:TACE联合动脉灌注ES组(A组)经肝动脉灌注ES 2 mg/kg、超液化碘油0.2 ml/kg及阿霉素2 mg/kg;TACE联合静脉注射ES组(B组)经肝动脉灌注超液化碘油0.2 ml/kg、阿霉素2 mg/kg,耳缘静脉注射ES 0.7 mg/kg·d(10 d);对照组(C组)经肝动脉灌注生理盐水10 ml,耳缘静脉注射生理盐水10 ml/d(10 d).干预处理前1 d及干预处理后10 d各组动物均行肝脏MRI检查,检查序列包括T1WI、T2WI及DWI.在ADW 4.2工作站上应用Function 2.0软件包对所得DWI图像进行后处理得到肿瘤及肝实质的ADC图并记录ADC值.用SPSS 16.0对实验数据进行统计学分析.结果 干预处理前:①各组动物肿瘤的ADC值均小于相应肝实质的ADC值(P<0.05);②各组动物肿瘤ADC值之间的差异及正常肝实质ADC值之间的差异均无统计学意义(P>0.05).干预处理后:①A、B组肿瘤ADC值较干预前分别升高25.60%、93.54%(P<0.05);② A、B组肿瘤的ADC值高于C组(P<0.05);③B组肿瘤的ADC值及干预前后升高幅度均高于A组(P<0.003).结论 TACE联合动脉灌注ES和TACE联合静脉注射ES对兔VX2肝脏移植瘤治疗后早期均有较好的疗效,且后一种方式的疗效优于前者.%Objective To explore the influence of recombinant human endostatin (ES) in different administration routes on VX2 carcinoma implanted in rabbit liver using magnetic resonance diffusion-weighted imaging ( MR-DWI ).Methods Twenty-four VX2 liver tumor's models were successfully established by open laparotomy and randomly divided into three groups( 8 rabbits in each group).Planar sonography was applied to detect the size and growth of the tumors after the implantation.When the tumor volume was 1 cm3, the following planned interferences were started: lipiodol (0.2 ml/kg).Adriamycin (ADM, 2 mg/kg) and ES ( 2 mg/kg) were administered via hepatic artery of the rabbits in arterial perfusion administration group(Group A, n=8); lipiodol (0.2 ml/kg) and ADM (2 mg/kg) were administered via hepatic artery, as well as ES (0.7 mg/kg · d) via a marginal ear vein of the rabbits in intravenous injection administration group(Group B, n=8 ); 10ml normal saline was administered via hepatic artery and normal saline (10 ml/d) via a marginal ear vein of the rabbits in the control group(Group C, n=8).MR imaging was performed one day before and ten days after the above mentioned interference.MR imaging protocols included T1 WI, T2 WI and DWI.DWI images of each rabbit liver were post-processed using Function 2.0 software package on ADW 4.2 workstation to obtain the apparent diffusion coefficient (ADC) maps, and ADC values were recorded before and after treatment.The data were analyzed using SPSS 16.0 for Windows.Results Before the interference, the ADC values of the tumors of rabbits were lower than that of liver parenchyma in each group (P＜0.05); there was no statistical difference in ADC values among each tumor, and so did that of the liver parenchyma.After the interference, the ADC values of the tumors of rabbits in group A and group B were increased compared with that before the interference (P＜0.05); the ADC values of the tumors of rabbits in group A and group B were higher than that of group C (P＜0.05); the ADC values of the tumors of rabbits in group B were higher than that of the group A (P＜0.003).Conclusion Both TACE combined with ES administered via hepatic artery and TACE combined with ES administered via marginal ear vein of rabbit are effective for VX2 carcinoma implanted in rabbit liver in early stage, and therapeutic effect of the later method is superior to the former one.