ABSTRACT
Objective To analyze the blood supply and metabolism in the marginal area of foci of hepatic alveolar echinococcosis by quantitative perfusion parameters. Methods Thirty patients with hepatic alveolar echinococcosis were scanned with the Revolution CT and the images were analyzed. The perfusion parameters, such as the bloodflow (BF), time to peak (TTP), blood volume (BV), mean transit time (MTT) and hepatic arterial fraction (HAF) were compared among different groups. Results The BF, TTP, BV and MTT values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were significantly different (F = 24.579, 8.343, 20.535 and 21.843, all P<0.05), but the HAF values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were not significantly different in the hepatic alveolar echinococcosis patients (F = 2.621, P> 0.05) . Conclusion The whole hepatic perfusion Revolution CT can accurately and quantitatively analyze the alveolar echinococcosis foci, especially the peripheral infiltration zone, which has important guiding significance for the formulation of surgical plan.
ABSTRACT
Objective To analyze the blood supply and metabolism in the marginal area of foci of hepatic alveolar echinococcosis by quantitative perfusion parameters. Methods Thirty patients with hepatic alveolar echinococcosis were scanned with the Revolution CT and the images were analyzed. The perfusion parameters, such as the bloodflow (BF), time to peak (TTP), blood volume (BV), mean transit time (MTT) and hepatic arterial fraction (HAF) were compared among different groups. Results The BF, TTP, BV and MTT values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were significantly different (F = 24.579, 8.343, 20.535 and 21.843, all P<0.05), but the HAF values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were not significantly different in the hepatic alveolar echinococcosis patients (F = 2.621, P> 0.05) . Conclusion The whole hepatic perfusion Revolution CT can accurately and quantitatively analyze the alveolar echinococcosis foci, especially the peripheral infiltration zone, which has important guiding significance for the formulation of surgical plan.
ABSTRACT
Objective The retrograde isolated hepatic perfusion (RIHP) model was used to compare with the isolated hepatic perfusion (IHP) model in reducing the rate of normal hepatic tissue toxicity and peripheral drug leakage during chemotherapy in rat liver. Methods A total of 90 male Sprague-Dawley rats weighing 300-350 g were randomized into 3 groups with 30 rats in each. Group A: perfusion with Lactated Ringer'S Solution through arteria hepatica (RA) and portal vein (PV),the inferior vena cava was used as an outflow tract of perfusate. Group B: For isolated hepatic perfusion (IHP), Fluorouracil (5-FU) was added into the perfusate at a dose of 350mg/kg and introduced in to the liver through arteria hepatica, portal vein was perfused by Lactated Ringer'S Solution, and the inferior vena cava was used as an outflow tract of perfusate. Group C: by using retrograde isolated hepatic perfusion (RIHP), the solution which contains 350 mg/kg Fluorouracil (5-FU) was also introduced through arteria hepatica, the inferior vena cava was introduced with Lactated Ringer'S Solution;the portal vein was used as an outflow tract of the perfusate. On day 1, 3, 5 and 7 after the perfusion in all groups, blood serum ALT test and liver histopathology test were performed. The peripheral blood drug levels were measured with high performance liquid chromatographic(HPLC) system in group B and group C. Results The survival rate was 90%, 86.7% and 90% in group A, B and C,respectively. No statistically significant difference was observed in the survival rate among the 3groups. In all the three groups, serum ALT levels were the highest on the first day after IHP: (481.6±207.6)μmol/LingroupA;(1641. 6±658.0) μmol/LingroupBand( 913. 0±353. 5)μmol/Lin group C. Significant higher serum ALT levels were observed by comparing group B and C with A(P＜0. 05). Meanwhile, the serum ALT levels were significantly higher in group B than in group C (P＜0.05). The peaks of peripheral blood drug concentration during the perfusion were 131.2±29.4μg/ml in group B and 65.3±28. 4μg/ml in group C. Significant difference was observed (P＜0. 05). Liver biopsies of group A showed mild changes on the first day after IHP and returned to normal after 7 days. Group B showed severe changes on the first day after IHP and local necrosis still existed after 7 days. Group C showed moderate changes as compared with group B on the first day after IHP and also returned to normal after 7 days. Conclusion Retrograde isolated hepatic perfusion (RIHP) can reduce the liver toxicity compared to isolated hepatic perfusion (IHP). Hopefully, RIHP will be considered as a safer way in regional chemotherapy in liver cancer.