肺癌MRI动态增强模式与肿瘤血管生成的相关性研究  

Correlative study of enhancement patterns of dynamic contrast-enhanced MRI and angiogenesis in pulmonary carcinoma

作　　者：邹煜[1] 张敏鸣[1] 王丽君[2] 商德胜[1] 汪启东[1] 

机构地区：[1]浙江大学医学院附属第一医院放射科,杭州310003 [2]浙江大学医学院附属第一医院病理科,杭州310003

出　　处：《中华放射学杂志》2003年第12期1150-1155,共6页Chinese Journal of Radiology

基　　金：国家自然科学基金资助项目 ( 3 0 170 2 84);教育部留学回国人员科研启动基金资助项目 ( 1999 747)

摘　　要：目的　探讨肺癌MRI动态增强模式与肿瘤血管生成的关系。方法　对 4 8例手术、病理证实的肺癌于术前行动态增强MR扫描 ,绘制时间 信号强度曲线并计算动态增强MRI参数 ,如最大增强线性斜率 (steepestslope ,SS)、增强峰值 (peakheight,PH)、增强后第 1、2、4分钟时信号强度改变率(E1、E2 、E4)等 ,分析各动态增强MRI参数及强化形态学表现 ,并与肺癌的微血管密度 (microvasculardensity,MVD)作相关性分析。结果　 4 8例肺癌微血管密度均数为 (5 6 .0 7± 2 2 .6 1)条 /0 .74mm2 。其中鳞癌 (2 6例 )为 (4 4 .4 1± 16 .2 8)条 /0 .74mm2 ,腺癌 (2 2例 )为 (6 9.86± 2 1.4 7)条 /0 .74mm2 条 /0 .74mm2 ,MVD计数腺癌高于鳞癌 ,两者间差异有显著意义 (t =4 .6 6 6 ,P <0 .0 1)。动态增强MRI各参数SS、PH、E1、E2 、E4与肺癌MVD呈正相关 ,其中以SS与MVD相关性最强 (r=0 874 ,P <0 .0 1)。结论　肺癌的微血管密度是其在动态增强MRI上不同表现的病理生理学基础 ,肺癌MRI动态增强模式与肿瘤血管生成有良好的相关性。Objective To investigate the relationship between dynamic contrast-enhanced MRI-derived patterns and histological microvessel density (MVD) counts in pulmonary carcinoma. Methods Forty-eight patients with pathologic analysis-proved pulmonary carcinoma underwent dynamic contrast-enhanced MR imaging before operation. Dynamic contrast-enhanced MRI-derived parameters [steepest slope, SS; peak height, PH; and the change in signal intensity in percent at 1(E 1), 2(E 2), and 4(E 4) minutes] were calculated based on time-signal intensity curves. The statistical correlation tests were used to determine the strength of the relationship between enhancement parameters and microvessel density counts. Results For 48 tumors, the mean value of microvessel density was 56.07±22.61. Squamous cell carcinoma had a mean count of 44.41±16.28 vessels (n=26), whereas adenocarcinoma had significantly higher counts (69.86±21.47 vessels, n=22) than squamous cell carcinoma (t=4.666, P<0.01). There were statistically significant correlations between SS, PH, E 1, E 2, E 4, and MVD, respectively. The highest correlation, however, was between the SS and MVD (r=0.874, P<0.01). Conclusion Tumor microvessel density is the pathophysiological basis of the enhancement patterns of dynamic contrast-enhanced MRI in pulmonary carcinoma. Enhancement patterns of dynamic contrast-enhanced MRI have strong positive correlations with angiogenesis in pulmonary carcinoma.

关 键 词：肺癌 MRI 动态增强模式 肿瘤血管生成 相关性 磁共振成像 

分 类 号：R734.2[医药卫生—肿瘤] R730.4[医药卫生—临床医学]