摘要
目的探讨血管外膜植入125I粒子对血管影响及影像学诊断价值。方法将125I粒子对称性缝植于3只健康杂种犬右侧颈外静脉、颈内动脉两侧血管外膜上,每只12枚,粒子活度0.7mCi、间距6~10mm。分别饲养8、10、12个月后行X线平片、MSCTA、DSA及组织病理学检查,其中MSCTA采用MIP、SSD、VE、MPR等多种后处理图像观察。对侧颈部血管作对照。结果6根血管均见粒子处局部外膜纤维组织增生和内膜内皮细胞脱落,并随时间延长而明显,中膜与内膜弹力层无甚改变,未见血管狭窄、穿孔及血栓形成。平片显示了全部26枚粒子与分布,未能显示粒子与血管关系;CTA显示粒子旁血管狭窄3根、闭塞1根,粒子金属伪影严重、计数困难,源影像显示粒子周围组织增生;DSA清楚显示了粒子与血管关系,粒子周围所有血管均未见狭窄、血栓等异常。左侧颈动静脉未发现组织病理与影像学异常。结论血管外膜植入125I粒子可致血管辐射损伤,影像学尤其DSA是粒子植入术对血管影响较好的评价手段。
Objective To investigate the vascular reaction and safety of radioactive ^125 I seeds implantation on large blood vessels, and to determine the ability of imageology on evaluation of implantnduced vascular injury by comparison of histopathology. Methods Radioactive ^125 I seeds （0.7 mCi each） were stitched on vascular adventitia of the right internal carotid artery and external jugular vein of 3 healthy hybrid dogs. Six seeds were implanted symmetrically in both sides of each vessel wall with from 6 mm to 10 mm intervals. The left internal carotid artery and jugular vein were as contrast study. X-ray plain, MSCTA, DSA imaging and histopathology examination were performed 8-, 10-, 12-month after seed-implanted operation respectively. Virtual endoscopy （VE） and related 3D postprocessing imaging, such as MIP, SSD, MPR of MSCTA, were reconstructed to depict mainly vascular anatomy. Results Histopathology revealed that fiber hyperplasia occurred in adventitia of all the six arterial and venous vessels. No obvious changes in media and intimas, but time-increasing damage and exfoliation of endothelial cell were shown in all of them. No vessel stricture, no thromboembolia and no perforation or rupture of vessels occurred. X-ray plain films only detected all of the 26 seeds （two seeds left only in the affected eight-month-after-operation dog）. CTA found vessel narrowness in 3 and vascular occlusion in one of the six vessels while enhanced cicatrical tissues around perivascular seeds were depicted on the source images with pronounced seed-relative metal artifacts. Seeds could be numbered accurately in DSA but couldn＇t in CT. The space relationship between seeds and vessels was demonstrated clearly in both CT and DSA. All vessels were shown to be normal in DSA. There were no abnormal changes in imageology and histopathology of the left carotid artery and vein. Conclusion Radioactive ^125I seeds stitched in vascular adventitia can cause a little radiation damage to vessels. Imageology especially DSA was the better method to investigate the vascular injury induced by radioactive implants.
出处
《中国介入影像与治疗学》
CSCD
2007年第1期66-70,共5页
Chinese Journal of Interventional Imaging and Therapy
关键词
磺放射性同位素
近距离放射治疗
大血管损伤
影像学
动物
实验
Iodine radioisotopes
Brachytherapy
Injury of large blood vessels
Imageology
Animal, laboratory
