磁共振灌注成像在术前星形细胞瘤血管形成在体研究中的价值

Value of Perfusion Magnetic Resonance Imaging in Vivo Study of Angiogenesis in Astrocytomas Pre-operation

目的:研究星形细胞瘤磁共振灌注成像与肿瘤血管内皮细胞生长因子及肿瘤血管形成的相关性,评价磁共振灌注成像在术前肿瘤血管形成的在体研究中的价值. 方法:术前进行MRI成像检查且经手术病理证实的34例星形细胞瘤患者,其中Ⅰ～Ⅱ级(低分级)26例,Ⅲ～Ⅳ级(高分级)8例.运用自旋回波-回波平面成像(SE-EPI)技术行MR灌注成像.采用免疫组化方法(SP法)检测 34例人脑星形细胞瘤血管内皮细胞生长因子(VEGF)表达;Ⅷ因子相关抗原单克隆抗体免疫组织化学(SP法)染色显示微血管,测量微血管密度(MVD)表示肿瘤血管生成. 结果:34例星形细胞瘤最大rCBV与其对应的VEGF表达水平和对应的MVD呈显著正相关(r=0.604, P<0.001;r=0.625, P<0.001);高分级星形细胞瘤最大rCBV、VEGF表达和MVD显著高于低分级星形细胞瘤 (t= 3.0, 7.08, 3.37; P= 0.017,0.01,0.011). 结论:磁共振灌注成像在术前活体研究星形细胞瘤的肿瘤血管形成及评价肿瘤的良恶性和预后中很有价值.

Objective. To investigate perfusion MR vascular endothelial growth factor （VEGF） imaging and its relationship with the expression of and angiogenesis in astrocytoma.Methods： Thirty four patients with astrocytomas was examined by MRI and proved by surgery and pathology, and the number of grade Ⅰ - Ⅱ （low-grade） and grade Ⅲ-Ⅳ （high-grade） is 26 and 8 respectively. Perfusion MR images were obtained with spin-echo echo planar imaging （SE-EPI） techniques. Expression of VEGF was examined by immunohistochemical method of streptavidin-biotin-peroxidase（SP）. The vascular development was measured by micro-vascular density （MVD） which was immunostained with anti-factor Ⅷ-related antigen monoclonal antibody. Results. Both of the expression of VEGF and the angiogenesis in 34 cases of astrocytomas were found to be significantly correlated to the maximum relative cerebral blood volume （rCBV） （r= 0. 604,P〈0. 001;r =0.625, P〈0. 001, respectively）. The maximum rCBV and the expression of VEGF, MVD in high-grade astrocytomas was significantly higher than that in low-grade astrocytomas （t=3.0, P =0.017; t=7.08, P=0.01;t=3.37,P=0.011, respectively）. Conclusion. Perfusion MR ima ging may be a valuable method in in invo study of angiogenesis of astrocytomas and evaluating their malignant degree and prognosis.