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目的研究诱发性大鼠肝硬化性肝癌超顺磁性氧化铁(SPIO)增强MRI与电镜表现。材料与方法16只由二乙基亚硝胺(DENA)诱导的肝硬化性肝癌大鼠行肝脏SPIO增强前后MR扫描,再行肝脏病理学及电镜检查。结果肝癌在T1WI上为低或等低信号,T2WI为较高信号。SPIO增强T2WI上,正常肝实质、肝硬化组织信号强度(SI)较增强前明显下降,肝癌SI较增强前无明显下降,其对比噪声比(CNR)升高,病变显示清晰。SPIO增强T1WI上正常肝实质及硬化肝组织SI无明显下降,肝癌SI较增强前升高,其CNR较增强前降低,病变显示不清楚。电镜下正常肝组织枯否细胞(KC)内溶酶体丰富,可见较多黑色颗粒状SPIO粒子,胞浆内可见大的SPIO簇。肝硬化组织细胞间隔增宽,胶原纤维明显增多,KC数量无明显减少,其内溶酶体有所减少,可见散在SPIO粒子,胞浆内可见较大的SPIO簇。肝癌组织KC数量减少或消失,癌细胞内细胞器基本消失,核异型。结论诱导性大鼠肝硬化性肝癌MR信号表现与人类肝癌相似。SPIO增强肝脏信号改变和KC数量及吞噬功能有一定关系。SPIO增强T2WI不仅能提高肝癌的对比,且能间接反映KC数量,可以预测肝癌组织学分级。
Objective To study the enhanced MRI and electron microscopic findings of superparamagnetic iron oxide (SPIO) in induced rat hepatic cirrhosis. Materials and Methods Sixteen cirrhotic hepatocellular carcinoma (HCC) rats induced by diethylnitrosamine (DENA) were subjected to MR imaging before and after liver SPIO enhancement. Liver pathology and electron microscopy were performed. Results Liver cancer had low or low signal on T1WI and high signal on T2WI. SPIO enhanced T2WI, normal liver parenchyma, liver cirrhosis signal intensity (SI) decreased significantly compared with before enhancement, liver cancer SI did not significantly decreased compared with before enhancement, the contrast to noise ratio (CNR) increased, the lesions showed clear. SPIO enhanced T1WI on normal liver parenchyma and sclerosis liver SI no significant decline, liver cancer SI increased before the increase, the CNR decreased compared with before the increase, the lesions showed unclear. Electron microscopy normal liver tissue Kupffer cells (KC) lysosome is rich, more black granular SPIO particles visible cytoplasm large SPIO clusters. Liver cirrhosis cells widened, collagen fibers increased significantly, the number of KC no significant reduction in the lysosomes decreased, scattered SPIO particles can be seen in the cytoplasm larger SPIO clusters. The number of KC in HCC decreased or disappeared, organelles in cancer cells basically disappeared and nuclear atypia. Conclusions MR signals of induced rat cirrhotic liver cancer are similar to those of human liver cancer. SPIO enhanced liver signal changes and the number of KC and phagocytosis have a certain relationship. SPIO enhanced T2WI can not only improve the contrast of liver cancer, and indirectly reflect the number of KC, HCC histology can be predicted.