骨与软组织肿瘤三维动脉自旋标记成像、体素内非相干性运动弥散加权成像与病理组织学的对照研究  

A comparative study of magnetic resonance three-dimensional arterial spin labeling perfusion imaging, intravoxel inco- herent motion diffusion weighted imaging and pathology for musculoskeletal tumors

作　　者：徐凌斌 徐雷鸣[2] 董海波[1] 朱海东[1] 罗雪芬[1] 张泳 

机构地区：[1]宁波市医疗中心李惠利医院放射科,315041 [2]浙江大学医学院附属第二医院影像科 [3]中国通用电气医疗集团磁共振研究部

出　　处：《中华骨科杂志》2014年第11期1161-1166,共6页Chinese Journal of Orthopaedics

摘　　要：目的探讨肿瘤血管生成指标即微血管密度（microvessel density，MVD）与肿瘤良恶性的关系，分析肿瘤血流量（tumor blood flow，TBF）、标准表观弥散系数（standard apparent diffusion coefficient，standard ADC）、慢速表观弥散系数（slow apparent diffusion coefficient，slow ADC）和快速表观弥散系数（fast apparent diffusion coefficient，fast ADC）与MVD的相关性。方法2013年3月至2013年6月，共40例骨与软组织肿瘤患者纳入研究按肿瘤良恶性分为三组，均同时行三维动脉自旋标记（three dimensional arterial spin labeling，3D．ASL）成像与体素内非相干性运动弥散加权成像（intravoxel incoherent motion diffusion weighted imaging，IVIMDWI）检查，选取肿瘤实质部分为感兴趣区（regionsofinterest，ROI）获得TBF、standardADC、fastADC和slowADC。运用免疫组织化学CD34染色计数肿瘤组织的MVD。MVD在三组间的差异采用单因素方差分析one—wayANOVA）。将TBF、standardADC、fastADC和slowADC等参数与MVD行Pearson相关性检验。结果良性肿瘤MVD为（10．38±4．58）条／0．26mm2，交界性肿瘤为（14．64±6．69）条，0．26mm2，恶性肿瘤为（32．97±11．61）条／0．26mm2，三组差异有统计学意义（F=28．83，P〈0．05），良性组、交界性组MVD值与恶性组的差异有统计学意义，良性组与交界性组MVD值差异无统计学意义。TBF与MVD呈正相关（r=0．784，P=0．000），fastADC与MVD呈中度正相关（r=0．516，P=0．000），fastADC与TBF呈正相关（r=0．727，P=0．000）。slow ADC、standardADC与MVD无相关性。结论MVD反映了肿瘤的生物学行为，3D—ASL和IVIM通过反映MVD，可以实现在体、安全、快速、无创、可重复性评价肿瘤的血管生成情况。Objective To explore the relationship between the tumor angiogenesis index （microvessel density, MVD） and biological behavior of the tumor. To analyze the correlations between TBF, standard ADC, fast ADC, slow ADC and MVD counts. Methods From March 2013 to June 2013, a total of 40 patients were involved in the study. 3D-ASL and IVIM DWI were both performed on patients with musculoskeletal tumors. TBF, standard ADC, slow ADC, fast ADC were measured by regions of interest. Immunohistochemical staining of specimens were performed by using CD34 monoclonal antibody to calculate MVD counts. Group differences in MVD were assessed by using one-way ANOVA. The correlations between TBF, standard ADC, fast ADC, slow ADC and MVD counts were evaluated using Pearson correlative analysis. Results The MVD of benign tumors was （10.38± 4.58）/0.26 mm2, the MVD of intermediate tumors was （14.64±6.69）/0.26 mm2, and the MVD of malignant tumors was （32.97 ± 11.61）/0.26 mm2. The differences of MVD among three groups were statistically significant （F=28.83, P〈0.05）. The differences of MVD between benign and malignant group were statistically significant （P〈0.05）, as well as intermediate and malignant group （p= 0.000）. There was a significant positive correlation between TBF and MVD （r=0.784, P=0.000）, as well as the correlation between TBF and fast ADC（r=0.727, P=0.000）. There was a moderate positive correlation between fast ADC and MVD （r=0.516, P=0.000）. There were no significant correlation between slow ADC and MVD, or between standard ADC and MVD. Conclusion The MVD represents the angiogenesis of musculoskeletal tumors, reflecting biological behavior of the tumor. ASL and IVIM DWI can be ap- plied to evaluate the angiogenesis of musculoskeletal tumors by reflecting MVD of musculoskeletal tumors in vivo as a completely noninvasive technique.

关 键 词：骨肿瘤 软组织肿瘤 血管 磁共振成像 病理学 

分 类 号：R738[医药卫生—肿瘤]