Objective To explore adaptive condition of preparation of animal model and afford reliable and stable model animal for further research on clinical diagnosis and treatment of cavernous transformation of portal vein (CTPV) by establishment of animal model by partial portal vein stenosis. Methods According to different straight blunttip needles used, 80 healthy Sprague-Dawley rats were randomly averagely divided into 4 groups: sham operation group, gauge 19 (19G) group, gauge 21 (21G) group and gauge 23 (23G) group. Six weeks after model making, pressure measurement and angiography of portal vein and pathological examination of portal vein and its surrounding tissues were used to evaluate portal hypertension and CTPV. Results Six weeks after model making no rat died in sham operation group, while the numbers of died rats in 19G group, 21G group and 23G group were 2, 4 and 16, respectively. No portal hypertension was displayed in sham operation group and 19G group 6 weeks after model making. Portography showed that the portal vein seemed smooth without variceal and dilatation in sham operation group and 19G group. Pathological examination demonstrated that the portal vein walls were not enlarged, endothelial cells were smooth. The smooth muscles of middle membrane were not thickened and adventitia was intact. Portal pressure increased and CTPV formed in 21G group and 23G group 6 weeks after model making. Portography showed that collateral circulation formed around portal vein in 21G group and 23G group. The vessel lumens with different size and irregular shapes were displayed by pathological examination. Within the narrow fibrous septum between there were the lumens the fat cells, scattered lymphocytes and mast cells, etc. The portal vein walls were enlarged notably, endothelial cells were damaged, the smooth muscle of middle membrane were thickened, thrombosis were formed. Conclusion Establishment of CTPV animal models by partial portal vein stenosis is a reliable method. 21G blund-tip needles fits well in the preparation of CTPV, which is reliable and stable with lower mortality.
Objective To review the advancement of surgical therapy for cavernous transformation of portal vein. Methods The relevant literatures on therapy for cavernous transformation of portal vein in recent years were collected and reviewed. Results The main symptoms of the patients are repeated haematemesis and hemafecia, hypersplenotrophy and hypersplenia. Most cases can be detected by ultrasonography or portal venography. Splenectomy and by-pass technique plus disconnection are the preferred operation. Conclusion Therapy for cavernous transformation of portal vein will be further developed.
【Abstract】Objective To investigate the appropriate reconstruction techniques of multidetectorrow spiral CT angiography (MDCTA) to depict the collateral vessels in cavernous transformation of the portal vein (CTPV) caused by tumor thrombosis of hepatocellular carcinoma (HCC). Methods MDCTA scanning was performed during the portal venous phase after intravenous contrast materials in 18 HCC patients with CTPV induced by tumor thrombosis. Raw data were reconstructed with thin slice thickness followed by 2D and 3D angiographic reconstruction methods, including maximum intensity projection(MIP), shade surface display （SSD） and volume rendering technique(VRT). Results MDCTA with MIP reconstruction accurately depicted both the tumor thrombus within the portal vein and the collateral vessels of CTPV including the biliary (cystic vein and pericholedochal veinous plexus) and the gastric (left and right gastric veins) branches. However, VRT and SSD methods did poorly in showing the tumor thrombus and the collateral vessels. Conclusion MDCTA with MIP reconstruction is the method of choice to evaluate the collateral vessels of CTPV.
Objective To observe the expression levels of nuclear factor kappa B （NF-κB）， vascular endothelial growth factor （VEGF）， and CD31 in portal vein and surrounding tissues of rats during the formation process of cavernoustransformation of portal vein （CTPV）， and try to search the relationship between NF-κB， VEGF， and the angiogenesisof portal areas， as well as the significance and the role of NF-κB and VEGF in the formation process of CTPV. Methods One hundred and ten Sprague-Dawley （SD） rats were randomly （random number method） divided into sham operation group and model group. The partial constriction operations on portal vein were performed in model rats with a blunt 21Gcaliber to establish CTPV animal models （model group）， while the exploratory operations on portal vein， not constriction，were performed in rats of sham operation group. All specimens （portal vein and surrounding tissues） were fixed in formalinand made into paraffin blocks. Each specimen was tested by immunohistochemistry for the expressions of NF-κB， VEGF， and CD31， then optical density （OD） of NF-κB expression and the mean integral optical density （IOD） of VEGF expressionwere measured by using Image Pro Plus 6.0 software， and microvessel density （MVD） was calculated under microscope. Results Nucleoplasm ratio of OD value of NF-κB， mean IOD value of VEGF， and MVD value in 1， 2， 3， 4， and 6 weeks after operation didn’t significantly differed from that of before operation in sham operation group （P＞0.05）， but higher at all time points after operation in model group （P＜0.01）. Compared with sham operation group， nucleoplasm ratio of OD value of NF-κB， mean IOD value of VEGF， and MVD value were significantly higher in 1， 2， 3， 4， and 6 weeks after operation in model group （P＜0.01）. NF-κB and VEGF， NF-κB and MVD， VEGF and MVD were positively correlated with each other （r=0.654 6，P＜0.01；r=0.620 7， P＜0.01；r=0.636 9， P＜0.01） in model group. Conclusion NF-κB and VEGF may relate to the formation of CTPV， and may involve in the angiogenesis.