| Objectives:Liver injury induced by chemotherapeutic drugs in rabbits was compared with that in blank control group.To explore the application value of Intravoxel Incoherent Motion(IVIM)and Iterative Decomposition of water and fat with Echo Asymmetry and Least squares estimation-Intelligent Quantification(IDEAL-IQ)in qualitative diagnosis and differential diagnosis of liver injury.Methods:Forty healthy female New Zealand white rabbits,aged 6 months and weighing about 2.5 kg,were randomly divided into four groups with 10 rabbits in each group.Group A was a blank control group,which was fed on a normal standard diet for 27 weeks.The remaining 30 rats were given AC regimen(31 mg/kg body weight of cyclophosphamide+3.3mg/kg body weight of epirubicin,intravenous injection of ear vein every 3 weeks)and normal diet.The experimental periods of group B,C and D were respectively 9 weeks,18 weeks and27 weeks.Before and after the beginning of the experiment and the end of the experimental periods,the blood of the ear vein was taken for liver function and routine blood test,and CT plain scan,IVIM and IDEAL-IQ scanning were performed.After the end of each experimental period,the rabbits were deeply anesthetized by uratan and the rabbit livers were taken out for pathological examination.The results of all tests and the pathologies were compared with those of CT plain scan,IVIM and IDEAL-IQ.Results:1.Laboratory tests showed that:There were no statistical differences in AST,ALT,ALP,TG and TC among the four groups before the experiment(P>0.05).After the end of the experimental periods,there were no statistical differences in AST,ALT,ALP,TG and TC between group A and pre-experiment indexes(P>0.05).AST,ALT and ALP in group B,C and D were higher than those in group A,and the most obvious in group D.There were statistical differences between group C,D and group A,B in AST,ALT and ALP respectively(P<0.05).There were also statistical differences in AST and ALT between C and D groups(P<0.05),except ALP(P>0.05).There were no statistical differences in AST,ALT and ALP between group A and group B(P>0.05).TC of group B,C and D was lower than that of group A after the end of the experimental periods,and the differences between group A and group D were statistically significant(P<0.05).Although the TG index fluctuated slightly,there were no statistical differences among the four groups(P>0.05).2.Routine CT plain scan showed that:Before the beginning of the experiment,the CT appearances of the four groups were that the size and shape of liver were normal,and the density of liver parenchyma was even and normal,and there were no statistical differences in CT values measured(F=0.957,P>0.05).After the end of the experimental periods,the CT performances of rabbit livers in group A were similar to those before the beginning of the experiment,and there were no statistical differences in CT values measured between group A and pre-experiment indexes(P>0.05).There were no significant differences in liver performances between group B and group A at the end of the experimental periods.The density of rabbit liver in group C was slightly lower than that in group A and B,and the CT values measured were decreased.At the end of the experimental periods in group D,the volume of rabbit liver increased slightly,the density of rabbit liver decreased further,and the CT values measured decreased correspondingly,and the density of liver parenchyma in group C and D was slightly uneven.There were significant differences in liver CT values among different groups after statistical analysis(F=6.049,P<0.05).The results obtained by SNK-q test showed that the CT values of liver in group D were lower than that in group A,and there were statistical differences between both of them(P<0.05),but there were no statistical differences among other groups(P>0.05).3.IVIM data showed that:There were no statistical differences in ADC,D value,D~*value and f value between the four groups before the experiment started(P>0.05).At the end of each experimental period,the ADC values of routine parameters measured showed a downward trend,but there were no statistical differences among the groups(F=2.298,P>0.05).In IVIM parameters,the changes of D values among groups also showed a downward trend,but there were no statistical differences(F=0.615,P>0.05).There were statistical differences in D~*values among groups(F=7.459,P<0.05).D~*values of C and D groups were significantly lower than those of A group,and the differences were statistically significant(P<0.05).There were statistical differences in f values among groups(F=4.336,P<0.05).Although the f values of group C were higher than that of group A and B,there were no statistical differences among the three groups(P>0.05).The f values of group D were significantly lower than that of the other three groups,and there were statistical differences between group C and D(P<0.05),but there were no statistical differences between other groups(P>0.05).4.IDEAL-IQ data showed that:There were no statistical differences in PDFF values before the beginning of the experiment(F=0.484,P>0.05).After the end of the experimental period,the PDFF values of each group increased slightly but there were no statistical differences among the all groups(F=0.311,P>0.05).5.Pathologic results showed that:In group A,under low power microscopy,the hepatocytes were centered around the central vein and distributed in a radial pattern.The hepatic sinuses were normal in shape,the bile ducts were clear,and the hepatocytes under high power microscopy were normal in structure.The performances of group B were similar to that of group A.In group C,the structure of hepatic lobules was clear and the arrangement of hepatocytes was regular under low power microscopy.At high power microscopy,the central vein of hepatic lobules and the hepatic sinusoids around it were dilated to various degrees,and a few hepatocytes were edema.In group D,the structure of hepatic lobules was clear under low power microscopy,the arrangement of hepatocytes was not regular.Hepatic sinusoids dilated in portal area,hepatocyte edema degeneration and a few eosinophilic changes were observed under high power microscopy.Small vacuoles and lymphocyte infiltration and fibrous tissue hyperplasia in portal area and perisinus were seen in the cytoplasm of a small number of hepatocytes.Conclusions:1.Obvious steatosis injury to hepatocytes can not be caused by short-term application of cyclophosphamide combined with epirubicin chemotherapy.Hepatic sinusoidal dilatation can be caused by its early damage and liver fibrosis by its middle and late stages.The changes of hepatic micro-perfusion can be reflected by D~*value in IVIM.The degree of damage to liver caused by chemotherapy in 6 cycles is slight.The degree of liver injury can be reflected and the early liver fibrosis can be indicated by IVIM.2.For cyclophosphamide combined with epirubicin chemotherapy,hepatic sinusoidal dilatation and blood perfusion changes can not be reflected by IDEAL-IQ.But the liver damage caused by the combination of the two drugs is not steatosis which is proved by it indirectly.The pathological changes of liver injury can not be reflected by CT plain scan. |
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