脑星形细胞瘤VEGF表达与动态增强MRI及瘤周水肿的相关性研究  

The Study on Correlation of Dynamic Contrast Enhanced MRI Findings and Peritumor Edema with Expression of VEGF in Astrocytoma

作　　者：王建武[1] 冯学彬[1] 马玉山[1] 曾林群[1] 

机构地区：[1]北京市通州区潞河医院MR室,101149

出　　处：《临床放射学杂志》2006年第12期1111-1114,共4页Journal of Clinical Radiology

摘　　要：目的探讨脑星形细胞瘤动态增强及瘤周水肿与瘤体内血管内皮生长因子(VEGF)表达的相关性。资料与方法对35例星形细胞瘤术前采用快速小角度激发序列(Turbo FLASH)进行动态增强扫描,通过对时间-信号强度分析,获得对比剂首过期(FP)曲线的最大斜率(SS)。在MRI计算星形细胞瘤的瘤体体积和瘤周脑水肿体积,从瘤周脑水肿(包括瘤体)体积与肿瘤本身体积之比获得水肿指数(EI),评估脑水肿的程度。术后取病灶进行VEGF免疫组织化学染色,计算每一标本的VEGF表达程度,将VEGF表达与SS、EI分别进行相关分析。结果VEGF在不同级别的星形细胞瘤组之间的表达差异具有统计学意义(P<0.05);VEGF不同表达程度的星形细胞瘤之间的SS或瘤周水肿的EI差异有统计学意义(P<0.05)。星形细胞瘤的VEGF表达与动态增强MRI的SS及瘤周水肿的EI成正相关,r值分别为0.867和0.831。结论VEGF促进星形细胞瘤血管生成,血管通透性增高,瘤周水肿的形成。对星形细胞瘤动态增强MRI曲线分析和MRI上瘤周水肿程度的测定有助于预测星形细胞瘤的VEGF表达,为评估星形细胞瘤恶性程度和抗血管治疗提供依据。Objective To discuss the correlation of dynamic contrast enhanced MRI findings and peritumor edema with expression level of VEGF in astrocytoma. Materials and Methods Preoperative dynamic contrast enhanced MR scanning with Turbo FLASH sequence was performed in 35 patients with pathologically verified astrocytoma. The time signal intensity curve was analyzed. The steepest slope （SS） of the curve in ＂first pass＂ phase were obtained. Preoperative MRI was used to measure the volume of tumor and peritumor edema respectively. The formulae V = 4/3π × abc and EI = Vedema ＋ Vtumor/Vtumor were used to determine the Edema index （EI） . After the surgery, the expression level of VEGF was measured with imnmnohistochenfical technique in specimens. The correlation between the expression level of VEGF and SS. EI was analyzed. Results The expression of VEGF in astrocytome corresponded closely with its pathological grade （ P 〈 0.05）. The expression of VEGF was significantly positive correlated with the SS, EI （ r = 0. 867, r = 0. 831, P 〈 0.001 ）. Conclusion VEGF can precipitate the tumor angiogenesis, accelerate the permeability and peritumor edema. The analysis of the time signal curve of dynamic contrast enhanced MRI and the index of peritumor edema on MRI are helpful for predicting the VEGF expression in astrocytoma, which provide a useful parameter in predicting tumor malignant degree and guiding antivascular therapy.

关 键 词：星形细胞瘤 磁共振成像 动态增强 瘤周水肿 血管内皮生长因子 

分 类 号：R739.4[医药卫生—肿瘤]