Blood flow changes in hepatocellular carcinoma after the administration of thalidomide assessed by reperfusion kinetics during microbubble infusion -: Preliminary results
Blood flow changes in hepatocellular carcinoma after the administration of thalidomide assessed by reperfusion kinetics during microbubble infusion -: Preliminary results
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DOI：
10.1097/01.rli.0000188363.93670.45
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发表时间：
2006-01-01
影响因子：
6.7
通讯作者：
Tribelli, C
中科院分区：
文献类型：
--
作者：
Bertolotto, M;Pozzato, G;Tribelli, C
目的：探讨沙利度胺能否在不能治疗的肝细胞癌患者中产生微泡造影剂可检测到的肿瘤血管改变。材料和方法：连续11例不能治疗的肝细胞癌患者在接受沙利度胺治疗前和治疗期间进行超声造影检查。用注射器泵以0.10mL/S的恒速注入意大利米兰布拉科的典型肝癌结节及其周围肝实质，并根据数学函数SI=A(1exp(-βt))建模，其中平台信号强度A反映血容量百分比，时间常数β反映平均血流速度，其乘积A*β反映营养血流。结果：沙利度胺治疗3~6个月后，典型结节的体积明显缩小。用药前A、P、A*P分别为44+/-60刘、0.31+/-0.40秒和8.1+/-11.8刘/S。治疗15天(26+/-50刘和2.9+/-4.8刘/S，P<；0.01)、3个月(12+/-18刘和4.3+/-7.7刘/S，P<；0.01)和6个月(13+/-23刘和2.4+/-3.7刘/S，P<；0.05)，A、A*P均显著降低。结论：超声造影可有效评价沙利度胺治疗过程中肝细胞癌结节内血流参数的变化。
Objectives: We sought to investigate whether thalidomide is able to produce tumor vascular changes in patients with untreatable hepatocellular carcinoma (HCC) that can be detected using microbubble contrast agents.Materials and Methods: Eleven consecutive patients with untreatable HCC underwent contrast-enhanced ultrasound before and during thalidomide administration. Real-time destruction reperfusion kinetics was obtained from a representative HCC nodule and from the surrounding liver parenchyma during SonoVue infusion (Bracco, Milan, Italy) at a constant rate of 0.10 mL/s by using a syringe pump and modelized according to the mathematical function SI = A(1 exp(-beta t)) where the plateau signal intensity A reflects the percent blood volume, the time constant beta reflects the average speed of blood, and their product A*beta reflects the nutrient blood flow.Results: Size of the representative nodule reduced significantly 3 to 6 months after the start of thalidomide treatment. Before thalidomide administration A, P, and A*P of the index lesion were 44 +/- 60 LIU, 0.31 +/- 0.40 seconds' and 8.1 +/- 11.8 LIU/s, respectively). A and A*P reduced significantly after 15 days (26 +/- 50 LIU and 2.9 +/- 4.8 LIU/s, P < 0.01), 3 months (12 +/- 18 LIU, and 4.3 +/- 7.7 LIU/s, P < 0.01), and 6 months (13 +/- 23 LIU and 2.4 +/- 3.7 LIU/s, P < 0.05) of treatment. No statistically significant changes of the exponential time constant beta were observed, nor changes of A, beta and A*P in the liver parenchyma.Conclusions: Contrast-enhanced ultrasound can be used effectively to evaluate changes in perfusion parameters of HCC nodules during thalidomide administration.