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大鼠肝癌相关结节铁含量的MRI与病理对照研究

The Iron Content of Hepatocellular Carcinoma Associated Nodules: Study of Histopathology and MR Imaging

  • 摘要: 目的 探讨MRI铁测量技术在鉴别肝癌(HCC)相关结节中的应用价值。方法 将55只雄性Wistar大鼠随机分为实验组(n=44)与对照组(n=11),分别予以二乙基亚硝胺(0.01%)和灭菌自来水饮用,持续13周。实验组按肉眼观察分为以下亚组:肝硬化结节组、肝硬化结节合并HCC组、HCC组;实验组又根据镜检结果分为以下亚组: 再生结节(RN)组、低度不典型增生结节(LGDN)组、高度不典型增生结节(HGDN)组、HCC组。13周后行MRI T2加权成像(T2WI)和T2*加权成像(T2*WI)扫描,次日处死大鼠后行常规病理学检查和组织铁含量测定,分析结节的T2值和T2*值与铁染色分级及铁含量值之间的相关性。结果 肉眼观对照组(正常大鼠)、肝硬化结节组、肝硬化结节合并HCC组、HCC组组间T2值、T2*值逐渐延长,组织铁含量逐渐降低,组间T2值、T2*值、组织铁含量差异均有统计学意义(P<0.05)。T2值、T2*值与组织铁含量均呈低度负相关(r1=-0.364,P1=0.000;r2=-0.245,P2=0.018)。镜下观对照组(正常大鼠)、RN组、LGDN组、HGDN组、HCC组组间实质内、间质内铁染色差异均有统计学意义(P<0.05)。两两比较,部分组间差异有统计学意义(P<0.05)。HCC组实质内、间质内铁染色分级大体上较非HCC组低。结论 MRI T2值和T2*值与组织铁含量呈负相关,能大致反映结节铁含量的多少。定量测定HCC相关结节的T2值和T2*值对其鉴别诊断有一定的帮助。

     

    Abstract: Objective To explore the clinical value of MRI imaging of measuring the iron content for hepatocellular carcinoma (HCC) associated nodules. Methods 55 male Wistar rats were randomly allocated into a treatment and a control group, which were administered with diethyl nitrosamine (DEN) and the sterilized tap water. According to the macro pathology differences, the treatment groups were divided into three groups: cirrhotic nodules group, cirrhotic nodules with HCC group, and HCC group; According to the micro pathology differences, the treatment groups were divided into four groups: regenerative nodules (RN) group, low grade dysplastic nodules (LGDN) group, high grade dysplastic nodules (HGDN) group, and HCC group. After 13 weeks, the rats were scanned by MRI T2WI and T2*WI. The next day all rats were sacrificed for histological tests and tissue iron level determination. The correlations were statically analyzed between the values of T2, T2* and the grades of iron stain, the quantification of tissue iron. Results With macro pathology observation, the values of T2, T2* among control group (normal rats), cirrhotic nodules group, cirrhotic nodules with HCC group, HCC group were increased, while the quantification of tissue iron were decreased. Significant differences were found for T2, T2*and quantification of tissue iron in three groups (P<0.05). Low-grade negative correlations could be found between T2, T2* and quantification of tissue iron in whole samples (r1=-0.364, P1=0.000; r2=-0.245, P2=0.018). With micro pathology observation, there were significant differences among the control (normal rats), RN, LGDN, HGDN, and HCC groups for the grades of iron stain both in the essence and the interstitial (P<0.05). After comparison each two groups, significant differences were found among some groups for the grades of iron stain both in the essence and the interstitial (P<0.05). Generally the grades of iron stain for HCCs were lower than non-HCC both in the essence and the interstitial. Conclusion Negative correlation between T2, T2* and iron content demonstrats that T2 and T2* could roughly estimate the iron content in the cirrhotic nodules. T2 and T2* measurements could contribute to differential diagnosis of HCC nodules.

     

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