肝癌的DCE-MRI定量成像与微血管密度、Ki-67相关性研究  

Study of the Correlation Between Quantitative DCE-MRI Imaging Biomarker and Microvessel Density,Ki-67 in Hepatocellular Carcinoma

作　　者：袁灼彬[1] 郑晓林[1] 邹玉坚[1] 黄宁 王惠媚[3] 徐文[1] 张世豪[2] 

机构地区：[1]广东省东莞市人民医院放射科,523059 [2]广东省东莞市人民医院病理科,523059 [3]东莞市厚街医院超声科

出　　处：《临床放射学杂志》2017年第11期1648-1652,共5页Journal of Clinical Radiology

摘　　要：目的探讨肝癌MRI多期动态对比增强(DCE-MRI)灌注定量参数与微血管密度(MVD)、Ki67相关性。方法对37例经手术病理确诊肝细胞癌(HCC)患者进行自由呼吸下行全肝MRI灌注扫描,将所获得HCC灌注定量参数K^(trans)、K_(ep)、V_e、V_p值及微血管密度(MVD)、Ki-67进行统计学对照分析。结果 37例HCC患者中,病理分级高分化6例,中分化20例,低分化11例。高分化HCC K^(trans)、K_(ep)、V_e、V_p值分别是(1.09±1.40)min^(-1)、(3.04±3.08)min^(-1)、0.917±1.06、0.46±0.33,MVD 75.67±8.44,Ki-67 25.84±8.43。中分化HCC K^(trans)、K_(ep)、V_e、V_p值分别是(0.96±1.06)min^(-1)、(2.90±2.04)min^(-1)、0.620±0.67、0.12±0.09,MVD 66.43±11.19,Ki-67 41.50±1.99。低分化HCC K^(trans)、K_(ep)、V_e、V_p值分别是(0.58±0.59)min^(-1)、(2.08±1.36)min^(-1)、0.48±0.36、0.17±0.17,MVD 54.92±22.43,Ki-67 47.55±2.14。Ki-67与病理分级呈正相关(r=0.369,P=0.034);灌注定量参数K^(trans)、K_(ep)值与肿瘤MVD呈明显正相关(r值分别为0.765和0.747,P值均为0.000)。结论 DCE-MRI定量分析能够对肝癌内血管特性进行准确评估,为评价肿瘤组织的微循环功能状态提供新的诊断方法。Objective To investigate the relationship between quantitative dynamic contrast enhanced MRI（DCEMRI）parameters and microvessel density（MVD）,as well as Ki-67 in hepatocellular carcinoma. Methods 37 patients confirmed with hepatocellular carcinoma（HCC） by pathology were recruited in this study,and all subjects underwent liver DCE-MRI sequence under free-breathing mode. The correlation was analyzed between quantitative permeability parameters including K^trans,Kep,Ve,Vpand MVD,together with Ki-67. Kruskal-Wallis rank sum test and Spearman correlation were performed for statistical analysis. Results Each HCC was histologically classified based on the most predominant histological grade（well,moderately or poorly differentiated）,with 6 cases of highly differentiated HCC,20 cases of moderately differentiated HCC and 11cases of low differentiated HCC. In highly differentiated HCC,values of K^trans,Kep,Ve,Vp,MVD and Ki-67 were（1. 09 ± 1. 40） min^-1,（3. 04 ± 3. 08） min^-1,0. 917 ± 1. 06、0. 46 ± 0. 33,75. 67 ± 8. 44 and 25. 84 ±8. 43 respectively. In moderately differentiated HCC,they were（0. 96 ± 1. 06） min^-1、（2. 90 ± 2. 04） min^-1,0. 620 ±0. 67,0. 12 ± 0. 09,66. 43 ± 11. 19 and 41. 50 ± 1. 99 respectively. Those values were（0. 58 ± 0. 59） min^-1,（2. 08 ±1. 36） min^-1,0. 48 ± 0. 36,0. 17 ± 0. 17,54. 92 ± 22. 43 and 47. 55 ± 2. 14 respectively in poorly differentiated HCC. Ki-67 was positively correlated with pathological grade of HCC（r = 0. 369,P = 0. 034）. Quantitative permeability parameters K^trans and Kepwere positively correlated with MVD of HCC（r = 0. 765 and 0. 747 respectively,P = 0. 000））. Conclusion Quantitative DCE-MRI analysis could accurately assess the vascular characteristics of HCC,and provide a new diagnostic method for evaluating the microcirculation function of tumor tissue.

关 键 词：微血管密度 肝细胞癌 病理分级 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]