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Abstract：
This work describes a comprehensive study of the vascular tree and perfusion characteristics of normal kidney and renal cell carcinoma. Methods: Nephrectomy specimens were perfused ex-vivo, and the regional blood flow was determined by infusion of radioactive microspheres. The vascular architecture was characterized by micronized barium sulphate infusion. Kidneys were subsequently sagitally sectioned, and autoradiograms were obtained to show the perfusate flow in relation to adjacent contact X-ray angiograms. Vascular resistance in defined tissue compartments was quantified, and finally, the tumor vasculature was 3D reconstructed via the micro-CT technique. Results show that the vascular tree of the kidney could be distinctly defined, and autoradiograms disclosed a high cortical flow. The peripheral resistance unit of the whole perfused specimen was 0.78 ± 0.40 (n = 26), while that of the renal cortex was 0.17 ± 0.07 (n = 15 with 114 samples). Micro-CT images from both cortex and medulla defined the vascular architecture. Angiograms from the renal tumors demonstrated a significant vascular heterogeneity within and between different tumors. A dense and irregular capillary network characterized peripheral tumor areas, whereas central parts of the tumors were less vascularized. Despite the dense capillarity, low perfusion through vessels with a diameter below 15 µm was seen on the autoradiograms. We conclude that micronized barium sulphate infusion may be used to demonstrate the vascular architecture in a complex organ. The vascular resistance was low, with little variation in the cortex of the normal kidney. Tumor tissue showed a considerable vascular structural heterogeneity with low perfusion through the peripheral nutritive capillaries and very poor perfusion of the central tumor, indicating intratumoral pressure exceeding the perfusion pressure. The merits and shortcomings of the various techniques used are discussed.
摘要：
这项工作描述了对正常肾脏和肾细胞癌的血管树和灌注特征的全面研究。方法:肾切除标本离体灌注,通过输注放射性微球测定局部血流量。血管结构的特征在于微粉化硫酸钡输注。随后对肾脏进行了矢状剖切，并获得了放射自显影图，以显示与相邻的接触X射线血管造影图有关的灌注液流量。定量确定的组织区室中的血管阻力，最后，通过显微CT技术对肿瘤血管进行三维重建。结果表明，肾脏的血管树可以明确定义，放射自显影显示皮质流量高。整个灌注试样的外周阻力单位为0.78±0.40(n=26),而肾皮质为0.17±0.07(n=15，114个样本)。来自皮质和髓质的显微CT图像定义了血管结构。来自肾肿瘤的血管造影显示不同肿瘤内部和之间的显著血管异质性。以周围肿瘤区域为特征的密集和不规则的毛细血管网络，而肿瘤的中央部分血管化程度较低。尽管有密集的毛细管作用，在放射自显影图上看到通过直径小于15µm的血管的低灌注。我们得出的结论是，微粉化硫酸钡输注可用于证明复杂器官中的血管结构。血管阻力低,正常肾脏的皮质几乎没有变化。肿瘤组织表现出相当大的血管结构异质性，通过外周营养毛细血管的低灌注和中央肿瘤的非常差的灌注，指示肿瘤内压力超过灌注压力。讨论了所使用的各种技术的优缺点。
