肿瘤血管生成的影像学评价  

Imaging evaluation of tumor angiogenesis

作　　者：陈波(综述 许健(审校)[1] 卢光明(审校)[1] 

机构地区：[1]南京军区南京总医院医学影像科,南京210002

出　　处：《医学研究生学报》2011年第2期196-202,共7页Journal of Medical Postgraduates

基　　金：国家自然科学基金(30930028);国家973计划项目(2006CB705707)

摘　　要：肿瘤生长依赖血管生成,抑制血管生已成为临床治疗肿瘤的方法之一,目前取得了初步效果。微血管密度(mi-crovessel density,MVD)是评价血管生成状态的"金标准",但由于操作困难在临床尚未广泛应用。常规的影像学检查方法难以评估肿瘤血管生成状态,不能对抑制血管生成治疗的效果进行客观评价,亟待选择适当的检查技术取代MVD测定。文中回顾相关文献并结合临床总结了评价肿瘤血管生成的各种影像学方法,包括肿瘤血管成像、CT双能量增强、CT灌注、动脉自旋标记(arterial spin labeling,ASL)血管成像、血氧水平依赖性(blood oxygen level-dependent,BOLD)MR成像、弥散加权成像(dif-fuse weighted imaging,DWI)、MR灌注、B超多普勒、B超增强和B超彩色多普勒能量成像、光学成像和核医学成像等。分子影像学在血管成像方面进展很快。每种成像方法原理不同,适用范围有差别,具有各自的优势和不足,临床应用时须进行鉴别,选择适当方法对抑制肿瘤血管生成的疗效进行评价。Tumor growth depends on angiogenesis,and therefore anti-angiogenesis has been widely used in the treatment of tumors.Microvessel density（MVD） is taken as the ＂golden standard＂ for assessing angiogenesis,though it has pitfalls in clinical practice.Routine imaging methods can neither reflect the real condition of tumor angiogenesis nor objectively evaluate the clinical effect of the anti-angiogenetic therapy.The authors reviewed the related literature and,based on the clinical experience,analyzed various imaging methods for assessing tumor angionenesis,including tumor angiography,double energy CT enhancement,CT perfusion,MR perfusion and MR diffuse weighted imaging（DWI）,MR blood oxygen level dependent imaging（BOLD）,ultrasonic strategies（such as Doppler blood flow imaging,color Doppler energetic imaging,and ultrasonic contrast enhancement）,PET/SPECT,and optic imaging.Molecular imagery approaches to vascularization have developed rapidly.Each method is unique for its imaging mechanism,features and applicability.In clinical practice,we should choose among all these techniques the most suitable one to avaluate the effect of anti-angiogenetic therapy.

关 键 词：肿瘤 血管生成 疗效评价 

分 类 号：R730.4[医药卫生—肿瘤]