肝门部胆管癌动态增强MRI对比剂空间分布与微血管密度的相关性研究

Spatial distribution of contrast agent and its correlation with microvessel density in dynamic contrast-enhanced MR imaging for hilar cholangiocarcinoma

目的探讨肝门部胆管癌动态增强MR对比剂空间分布与微血管密度(MVD)的相关性。方法对28例肝门部胆管癌术前行MR平扫、动态增强扫描,分析瘤中心、瘤边缘和瘤旁MR对比剂空间分布情况;术后标本行免疫组织化学染色,测定肿瘤MVD及分布情况,并分析与相应病灶MR对比剂空间分布之间的关系。结果肝门部胆管癌瘤内部MR对比剂空间分布有显著性差异,瘤边缘早期强化率(△SI)显著高于瘤中心;所有病灶ΔSI边缘、ΔSI中心均高于ΔSI瘤旁,肝门部胆管癌动态增强MR对比剂空间分布与MVD呈显著正相关。结论肝门部胆管癌动态增强MR对比剂空间分布与MVD密切相关,可根据动态增强MR对比剂空间分布推测癌灶的微血管数量和空间分布情况,以评估其临床预后。

Objective To investigate the spatial distribution of contrast agent in dynamic enhanced MR for hilar cholangiocarcinoma （HC）, and to discuss its correlation with microvessel density （MVD）. Methods Both plain and dynamic contrast-enhanced MR scanning was performed in 28 patients with HC before operation. The spatial distribution of MR contrast agent at the tumor＇s center and periphery and also in the space around the tumor was analyzed. The removed specimens were stained with conventional hematoxylin and eosin （HE）, and stained with immunohistochemistry to estimate MVD and its spatial distribution. The relationship between the spatial distribution of MR contrast agent and MVD was analyzed. Results Significant difference in the spatial distribution of MR contrast agent existed in HC. The enhancement rate （△SI） of the early-phase signal intensity at the peripheral area was significantly higher than that at the lesion＇s center. The △SI at the center and peripheral area was significantly higher than that of the area around. Obvious positive correlation existed between the spatial distribution of contrast agent and MVD. Conclusion Among the 28 HC with dynamic MR scans, there was positive correlation between the spatial distribution of contrast agent and MVD. The biologic behavior and prognosis of HC can be assessed according to the spatial distribution of contrast agent.