Sequential changes of sonographic and computed tomography findings in the normal rabbit liver after percutaneous ethanol injection - Correlation with pathologic findings
Sequential changes of sonographic and computed tomography findings in the normal rabbit liver after percutaneous ethanol injection - Correlation with pathologic findings
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DOI：
10.1097/00004424-199810000-00002
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发表时间：
1998-10-01
影响因子：
6.7
通讯作者：
Yoo, J
中科院分区：
文献类型：
--
作者：
Ahn, MI;Park, YH;Yoo, J
理论基础和目标。方法：30只麻醉兔在超声引导下经皮注射无水乙醇1m L，观察其超声和CT表现，并与病理结果对照。根据术后第1天(即术后即刻)、第3天、第1周、第2周、第4周的超声和CT检查次数，将动物分为5组，每组6只，分析造影剂注射前后的影像表现，包括声像图和密度图，并分析其与病理的关系。用超声和CT测量病变大小，并与病理标本的实际大小进行比较。B超和CT显示不同的影像表现，术后第1天100%(6/6)的兔肝脏呈高回声；术后1~4周超声表现为等回声(67%，12/18)或略低回声(22%，4/18)。术后第1天CT扫描显示100%(6/6)的兔肝脏呈清晰、低密度病灶，3天后88%(21/24)病灶呈稍低密度或较低密度，术后1周周围强化83%(15/18)。病理组织学检查显示血栓形成和萎缩的肝细胞索与术后即刻超声高回声和CT极低密度密切相关。凝固性坏死是3d后病变中心部的主要病理改变，与CT表现为中央性低密度无强化相关，I周后CT表现为周边肉芽组织和纤维化与周边强化相关。病变大小以第1周组最大，第1周组与第1天组差异有统计学意义。结论经PEI处理的正常兔肝脏超声和CT表现随时间变化规律可预测，并与病理结果相关。一周后，经PEI治疗的正常肝脏显示出结节状和不规则的病灶周围强化(特别是直到2周)；在使用常规CT检查评估PEI后的治疗效果时必须考虑到这一点。尽管缺乏长期数据，但由于难以区分强化的肿瘤和强化的纤维化，在PEI后第二周之前不应进行肿瘤残留的对照CT扫描。
RATIONALE AND OBJECTIVES. The authors assessed the sequential sonographic and computed tomographic (CT) findings and their correlations with pathologic findings of the normal rabbit liver after percutaneous ethanol injection (PEI).METHODS. In 30 anesthetized rabbits, 1 mL of ethanol was injected percutaneously under sonographic guidance. The animals were divided into five groups of six rabbits each according to the times of sonography and CT examinations after PEI: day 1 (immediately after), day 3, week 1, week 2, and week 4, The radiologic findings were analyzed regarding echogenicity (sonography) and density patterns before and after contrast administration (CT), The relations between radiologic findings and pathologic findings were examined using statistical analysis. The lesion size was measured using sonography and CT and compared with the actual size of the pathologic specimen,RESULTS. Sonography and CT showed various radiologic findings according to the time elapsed after PEI, The livers were hyperechoic in 100% (6/6) of the rabbits on day 1; this changed to isoechoic (67%, 12/18) or slightly hypoechoic (22%, 4/18) after week 1 through week 4 after PEI on sonography, CT scanning showed well-defined, hypodense lesions with no contrast enhancement in 100% (6/6) of the rabbits on day 1, and the lesions were slightly hypodense and relatively poorly defined in 88% (21/24) after day 3, Peripheral enhancement was noted in 83% (15/18) after week 1, Histopathologic examination revealed thrombosis and atrophic hepatic cell cords correlating well with hyperechogenicity on sonography and very low density on CT immediately after PEI, Coagulation necrosis was a main pathologic finding in the central portion of the lesions after day 3 and correlated with the CT findings of central low density without contrast enhancement, After week I, peripheral granulation tissue and fibrosis were correlated with peripheral contrast enhancement on CT. Lesion size was largest in the week 1 group, and the size difference was statistically significant between the week 1 group and the day 1 group.CONCLUSIONS. Sonographic and CT findings of the PEI-treated normal rabbit liver varied with time in a predictable manner and correlated with pathologic findings. After a week, the PEI-treated normal liver shows perilesional enhancement that is nodular and irregular (particularly until 2 weeks); this must be taken into account when evaluating the therapeutic effect after PEI using conventional CT studies. Although longterm data are missing, control CT scans for residual tumor should not be performed before the second week after PEI because of the difficulty discerning enhancing tumor from enhancing fibrosis.