兔肝vx2瘤不同生长时期的3.0 tmr、petct成像与病理的对照研究

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1、中图分类号：R445.2；R445.5；R361+.2；R735.7硕士学位论文兔肝VX2瘤不同生长时期的3.0TMR、PET/CT成像与病理的对照研究院（系）、所临床医学院研究生姓名牟晓庆学科、专业影像医学与核医学导师姓名唐光才教授二O一二年四月目录1兔肝VX2瘤不同生长时期的3.0TMR、PET/CT成像与病理的对照研究„„„„„„„„„„„„„„„„„„„11.1中文摘要„„„„„„„„„„„„„„„„„„„„21.2英文摘要„„„„„„„„„„„„„„„„„„„„71.3前言„„„„„„„„„„„

2、„„„„„„„„„„„131.4材料与方法„„„„„„„„„„„„„„„„„„„151.5结果„„„„„„„„„„„„„„„„„„„„„„211.6讨论„„„„„„„„„„„„„„„„„„„„„„281.7结论„„„„„„„„„„„„„„„„„„„„„„351.8参考文献„„„„„„„„„„„„„„„„„„„„361.9英汉缩略词对照表„„„„„„„„„„„„„„„„482致谢„„„„„„„„„„„„„„„„„„„„„„493兔VX2肝癌模型MR扩散加权成像研究现状及其临床意义（综述）„„„„„„„„„„

3、„„„„„„„„„„504在读期间发表的论文„„„„„„„„„„„„„„„59兔肝VX2瘤不同生长时期的3.0TMR、PET/CT成像与病理的对照研究摘要目的：探讨兔肝VX2瘤的3.0TMRDWI成像特征；比较3.0TMR全身弥散加权成像（WB-DWI）与PET/CT成像在兔肝VX2瘤诊断、淋巴结转移、远处转移评估中的价值与限度；分析兔肝VX2瘤的ADC值与SUV值的相关性；探寻一种更好的肝癌影像诊断、鉴别诊断及临床分期的影像学检查方法。材料和方法：新西兰大白兔23只，采用开腹直视下瘤块接种法，将成功建模

4、的16只实验兔依照兔肝VX2瘤的一般分期随机分为三组（即14天组6只、28天组6只及42天组4只），在对应的时间内采用Philips3.0T-Achieva/intera双梯度超导高场强MR扫描仪及PHILIPS16TOFPET/CT扫描仪进行MR及PET/CT检查，比较两种成像方法对病灶的检出情况。将实验兔全麻后俯卧固定于8通道膝关节相控阵线圈内，先行3.0TMR常规T1WI、Thrive、T2WI、T2W/SPIR横断扫描，观察不同时期、不同成像序列下VX2瘤的信号特点；然后行DWI扫描，b值分别取1

5、00、400、600、800s／2mm，以ADC值为指标评价DWI图像上不同时期、不同b值条件下VX2瘤与周围正常肝组织的差异；再换用Q-BODY线圈行WB-DWI扫描，图像经叠加、3DMIP及黑白翻转显示处理后，观察病灶位置、大小及远隔器官的受累情况。MR扫描结束后，立即经耳缘静脉建立18静脉通道注射F-FDG（1.0mCi/kg），注射药物后50-60min，行PET/CT检查；经PET/CT诊断医师确认放射性核素浓聚灶后，以SUV值为指标评价不同时期VX2瘤与周围正常肝组织的差异，并观察病灶位置、大

6、小及远隔器官的受累情况。所有检查结束后采用空气栓塞法处死实验兔，凡完成扫描WB-DWI及PET/CT检查的实验兔均行尸检，除肝脏外，发现淋巴结或远处脏器的转移灶均取标本送检，进行病理对照研究。统计学方法：数据以“均数±标准差”表示，统计软件运用SPSS13.0，P<0．05认为差异有统计学意义。比较DWI图像上同一时期、不同b值条件下VX2瘤与正常肝组织之间的ADC值差异及PET/CT图像上VX2瘤与正常肝组织之间的SUV值差异采用配对t检验；比较DWI图像上同一时期、不同b值条件下VX2瘤的ADC值差异

7、，不同时期、同一b值条件下VX2瘤的ADC值差异及28天组与42天组VX2瘤的SUV值差异采用一维方差分析；分析28天组与42天组VX2瘤在不同b值条件下的ADC值与SUV值的相关性采用Pearson相关。结果：①14天组3.0TMR常规序列及DWI共检出（7/7）个肝内病灶，PET/CT检出（0/7）个肝内病灶，瘤体最大径约0.5cm。28天组3.0TMR常规序列及DWI共检出(9/9)个肝内病灶，PET/CT检出（9/9）个肝内病灶，瘤体最大径约2.5cm；42天组3.0TMR常规序列及DWI共检出(

8、4/4)个肝内病灶及广泛的肝内小转移灶，PET/CT仅检出（4/4）个肝内病灶，瘤体最大径约5.0cm。②常规MRI图像上，在T1WI、Thrive所有VX2瘤均呈稍低信号，在T2WI、T2W/SPIR14天组呈均匀稍高信号、28天组与42天组呈不均匀稍高信号。DWI图像上，所有VX2瘤均呈明显高信号，28天组与42天组的肿瘤中心可2见斑片状低信号；随b值增大，DWI图像质量下降，b值为400s/mm时图像质量最好。ADC图则