DCE-MRI与脑胶质瘤级别及VEGF关系的研究  

Study on the Relationship Between DCE-MRI and Glioma Grade,As Well As Between DCE-MRI and VEGF Expression

作　　者：关婷婷[1] 王小宜[1] 侯磊[2] 周高峰[1] 韩再德[1] 孟莉[1] GUAN Tingting;WANG Xiaoyi;HOU Lei(Department of Radiology,Xiangya Hospital,Central South University,Changsha 410000 ,P.R.China)

机构地区：[1]中南大学湘雅医院放射科,长沙410000 [2]西弗吉尼亚大学

出　　处：《临床放射学杂志》2018年第12期1973-1979,共7页Journal of Clinical Radiology

基　　金：湖南省自然科学基金面上项目(编号:2017JJ2387)

摘　　要：目的评估动态对比增强磁共振成像(DCE-MRI)在术前诊断胶质瘤病理级别中的价值及与胶质瘤血管内皮生长因子(VEGF)表达的关系。方法搜集胶质瘤患者33例(Ⅰ级7例,Ⅱ级9例,Ⅲ级9例,Ⅳ级8例),正常对照者5名(对照组)。依次行常规MR扫描、DCE-MRI及常规增强扫描。通过经典Tofts双室模型、NORDICIC软件处理数据,获取容积转运常数(Ktrans)等参数值的伪彩图,参考常规T1WI增强图,以胶质瘤Ktrans值最高区域作为感兴趣区(ROI),计算Ktrans等参数的平均值。在MRI扫描后1周内33例患者均完成手术,并取其瘤组织标本经由间接法完成VEGF免疫组织化学测定。DCE-MRI各参数、胶质瘤级别、VEGF表达这三者之间的关系均使用Spearman秩相关分析。结果胶质瘤Ⅰ级的Ktrans值约为对照组的10倍。低级别(Ⅰ、Ⅱ级)胶质瘤DCE-MRI各参数值显著低于高级别(Ⅲ、Ⅳ级)。Ⅱ级胶质瘤和Ⅲ级胶质瘤的Ktrans存在差别。Ktrans值与胶质瘤病理分级紧密正相关(r=0.750,P<0.001),其区分高低级别胶质瘤的阈值为0.830(灵敏度为0.923,特异度为0.912)。VEGF在胶质瘤的表达与其级别正相关(r=0.695,P<0.001)。VEGF在胶质瘤的表达与DCE-MRI的Ktrans正相关(r=0.547,P=0.007)。结论 DCE-MRI各参数可定量评估脑胶质瘤微血管渗漏特点,Ktrans值在高低级别胶质瘤鉴别中的诊断效能最佳。VEGF在胶质瘤中的表达与DCE-MRI的渗透参数Ktrans值呈正相关。Objective To evaluate the value of DCE-MRI in preoperative pathological grading of gliomas and its relationship with VEGF expression.Methods 33 patients with glioma(7 cases of gradeⅠ,9 cases of gradeⅡ,9 cases of gradeⅢ,8 cases of gradeⅣ)and 5 healthy controls were recruited.MRI scanning was performed in an certain order of conventional scan,DCE-MRI scan,and routine enhancement scan.The pseudo-color map of Ktransand other parameter were obtained after data analysis through the NORDICIC software and classic Tofts dual-chamber model.The average of Ktransand other parameters was calculated after the area with the highest Ktransvalue of glioma was selected as the ROI referred to the traditional T1 enhancement map.33 patients completed the operation within 1 week after MRI scan,and VEGF immunohistochemistry was performed by indirect method after acquiring the patient's tumor tissue samples.The Spearman rank correlation analysis was used for the relationship among DCE-MRI parameters,glioma grade,and VEGF expression.Results The Ktransvalue of grade I glioma was about 10 times that of control group.The values of each parameter obtained from DCE-MRI of low-grade(GradeⅠ,Ⅱ)glioma were significantly lower than those of high grade(GradeⅢ,Ⅳ).There is a difference in Ktransbetween gradeⅡand gradeⅢglioma.The Ktransvalue is closely related to the pathological grade of glioma(r=0.750,P<0.001).The threshold of Ktransto differentiate high and low grade gliomas was 0.830(sensitivity0.923,specificity 0.912).The expression of VEGF in glioma was positively correlated with its grade(r=0.695,P<0.001).And the expression of VEGF in gliomas was positively correlated with the volume transport constant Ktransof DCE-MRI(r=0.547,P=0.007).ConclusionDCE-MRI parameters can quantitatively evaluate the glioma microvascular leakage characteristics.Ktransvalues shows the best diagnostic performance in the differentiation of high-low grade glioma.The expression of VEGF in glioma was positively correlated with the Ktrans-value of DCE-M

关 键 词：磁共振动态增强 胶质瘤病理分级 VEGF表达 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]