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目的研究超顺磁性氧化铁(SPIO)增强MRI表现的病理学基础及对肝病诊断的价值。方法52只SD大鼠随机分2组,模型组(40只)灌喂2‰二乙基亚硝胺(DEN),诱发肝癌,正常对照组(12只)仅给自由水饮用,分别于第6周,8周,11周,14周,17周,20周,模型组处死6只,对照组处死2只。处死前行影像学检查(MR平扫及SPIO增强扫描)。并行病理学检查及免疫组化SP法检测CD68表达。结果模型组诱癌成功率90%,死亡率15%。模型组分为肝纤维化期,肝硬化期,硬化增生结节期及HCC期4期。正常组的CD68阳性细胞数(22.83个±4.61个/高倍视野)多于模型组肝硬化期(11.67个±4.64个/高倍视野)(P<0.05),肝纤维化期阳性细胞数(24.67个±5.24个/高倍视野)多于肝硬化期(P<0.05),硬化增生结节CD68阳性细胞计数比(1.05±0.39)明显高于HCC(0.48±0.16)(P<0.01)。SPIO增强MRI后的信号下降百分比(PSIL)硬化增生结节(-0.37±0.23)与HCC结节(1.70±0.42)有差异(P<0.05)。结论SPIO增强MRI在肝脏弥漫性疾病,HCC及其它肝脏占位性病变的检出及诊断具有重要价值。
Objective To study the pathological basis of superparamagnetic iron oxide (SPIO) enhanced MRI and its value in the diagnosis of liver disease. Methods Fifty-two SD rats were randomly divided into two groups. The model group (40 rats) was infused with 2 ‰ diethylnitrosamine (DEN) to induce liver cancer. The normal control group (12) 6 weeks, 8 weeks, 11 weeks, 14 weeks, 17 weeks and 20 weeks. Six rabbits in the model group were sacrificed and two rabbits in the control group were sacrificed. Radiographic examinations (MR plain scan and SPIO enhanced scan) were performed. Parallel pathological examination and immunohistochemistry SP method to detect CD68 expression. Results The successful rate of cancer induction in model group was 90% and the mortality rate was 15%. The model components were liver fibrosis, cirrhosis, cirrhosis and HCC stage 4. The number of CD68 positive cells (22.83 ± 4.61 / high power field) in normal group was more than that in model group (11.67 ± 4.64 / high power field) (P <0.05), and the number of positive cells in liver fibrosis stage was 24.67 ± 5.24 / high power fields) than in cirrhosis (P <0.05). The ratio of CD68 positive cells in sclerosing nodules was significantly higher than that in HCC (0.48 ± 0.16) (P <0.01). There was a significant difference (P <0.05) between PSIL sclerosis (-0.37 ± 0.23) and HCC nodules (1.70 ± 0.42) after SPIO enhanced MRI. Conclusion SPIO enhanced MRI is of great value in the detection and diagnosis of diffuse liver diseases, HCC and other liver space-occupying lesions.