肝内胆管细胞癌剪切超声硬度与三维病理重建纤维各向异性关系的研究

项目名称： 肝内胆管细胞癌剪切超声硬度与三维病理重建纤维各向异性关系的研究

项目编号： No.81501488

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 凌文武

作者单位： 四川大学

项目金额： 18万元

中文摘要： HCC与ICC是最常见的两种原发性肝癌，准确区分二者对治疗和预后极为重要。ICC富含肿瘤纤维故质硬，我们术中对ICC标本进行机械弹性测定，其硬度明显大于HCC，故用于检测深部脏器硬度的剪切波超声弹性成像（SWE）有可能区分ICC与HCC。但已有研究却显示SWE测定的ICC硬度值差异大且变异大，考虑到SWE在检测有序纤维组织硬度时存在各向异性，推测已有研究可能是未考虑到ICC肿瘤纤维各向异性造成的。针对HCC与ICC鉴别存在困难的现状，本研究拟在前期基础上先对术中离体ICC及HCC标本用专用导丝定位，对该部位用SWE及机械弹性分别进行三个相互垂直方向的硬度测定；确定肿瘤类型后用胶原纤维染色获取连续数字病理图片序列，通过分水岭纤维组织分割、插值和网格法等重建肿瘤纤维三维影像，提取纤维量及各向异性参数；探索SWE及机械弹性与肿瘤纤维量和各向异性之间的关系，为ICC与HCC的鉴别提供更多诊断信息。

中文关键词： 肝内胆管细胞癌；剪切超声硬度；三维病理；各向异性

英文摘要： HCC and ICC are the two most common types of liver carcinoma. Accurately distinguish between the two tumors is extremely important for treatment and prognosis. The periphery of ICC usually comprises of fibrous tissue, therefore it is hard. Our previous stiffness measurements on the ICC from surgical specimens by using a mechanical method showed significantly higher stiffness values as compared to HCC. The newly developed shear-wave based ultrasound elastographies have potential in discrimination ICC from HCC. However varies SWE measurements with large coefficients of variation have been demonstrated across different researches. These might be caused by the anisotropy of fibrous tissues on ICC when accessing its stiffness using SWE. Based on our previous study, in this research, surgical specimens from ICC and HCC will be marked by the guide wires. Then their stiffness will be accessed by SWE and tissue elastometer respectively from three orthogonal directions. Then collagen fiber staining will be performed on the consecutive slices from the marked specimens and the digital pathology images will be acquired. After the watershed fiber segmentation and image interpolation, the three dimensional image of the fibrous tissue will be reconstructed using mesh-grid method. The quantity of fibrous tissue and parameters characterizing the anisotropy property of the fibrous tissue will be further extracted. Finally, the association of SWE measurements and tissue elastometer measurements as respect to the related parameters will be analyzed，which can provide more diagnostic information for accurate identification of ICC and HCC.

英文关键词： Intrahepatic cholangiocarcinoma;Shear-wave based ultrasound elastography;Three-dimensional pathology;Anisotropy property