磁共振扩散加权成像评价肝外胆管癌肿瘤血管生成及病理分级的价值  

The Value of Diffusion Weighted Imaging in Estimating Tumor Angiogenesis and Pathologic Grading of Extrahepatic Cholangiocarcinoma

作　　者：王余 彭鹏 张宇新[3] 夏庆安 王海平 韩德昌 

机构地区：[1]河北省唐山市工人医院磁共振室,063000 [2]河北省唐山市工人医院肝胆外科,063000 [3]河北联合大学基础医学院 [4]河北省唐山市工人医院病理科,063000

出　　处：《临床放射学杂志》2014年第2期248-254,共7页Journal of Clinical Radiology

基　　金：2010年唐山市科学技术研究与发展计划指导项目(编号:10130251a)

摘　　要：目的探讨磁共振扩散加权成像(DWI)评价肝外胆管癌肿瘤血管生成及病理分级的价值。方法对57例肝外胆管癌患者术前行常规MRI、DWI(b值为800 s/mm2)、DCE-MRI扫描,测量肝外胆管癌病灶的表观扩散系数(ADC)值;术后采用免疫组织化学方法检测肝外胆管癌标本组织的微血管密度(MVD)、血管内皮生长因子(VEGF)表达,分析ADC值与MVD、VEGF及病理分级的关系。结果肝外胆管癌病灶ADC值与MVD存在负相关性(r=-0.36 P<0.05);肝外胆管癌标本组织VEGF表达阳性组的ADC值明显低于VEGF表达阴性组(t=2.68P<0.05);不同分化肝外胆管癌病灶的ADC值随着病理分级的升高而减低(F=18.51 P<0.05)。结论 ADC值能反映肝外胆管癌肿瘤血管生成水平高低及预测其病理分级,DWI有助于在活体上对肝外胆管癌生物学特性进行评估。Objective To investigate the value of diffusion weighted imaging （DWI） in estimating tumor angiogenesis and pathologic grading of extrahepatic cholangiocarcinoma. Methods Routine MRI, DWI （ b = 800 s/mm2 ） and DCE- MRI scanning were performed in fifty seven patients with extrahepatic cholangiocarcinoma before operation. ADC value of extrahepatic cholangiocarcinoma was measured. MVD and VEGF expression were detected in extrahepatic cholangiocarcino- ma tissue samples using immunohistochemical methods after operation. The relations between ADC value and MVD, VEGF or pathologic grading of extrahepatic cholangiocarcinoma were analyzed. Results There was negative correlation between ADC value and MVD of extrahepatic cholangiocarcinoma （r = -0. 36, P 〈 0.05 ）. The ADC value of extrahepatic cholaugio- carcinoma with positive VEGF expression was lower than that with negative VEGF expression（ t = 2.68,P 〈 0.05 ）. ADC value decreased with pathologic grading increasing （ F = 18.51 ,P 〈 0.05 ）. Conclusion ADC value can reflect tumor an- giogenesis and predict pathologic grading in extrahepatic cholangiocarcinoma, and DWI contributes to evaluating the biologi- cal features of extrahepatic cholangiocarcinoma in vivo.

关 键 词：胆管癌 扩散加权成像 肿瘤血管生成 表观扩散系数 微血管密度 血管内皮生长因子 病理分级 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.8[医药卫生—诊断学]