CT灌注成像评价肾癌血管生成

CT perfusion imaging for the assessment of tumor vascularity in renal carcinoma

目的观察肾癌CT灌注成像参数与组织学肿瘤微血管密度(MVD)和肿瘤血管成熟指数(VMI)之间的关系,探讨CT灌注成像无创的评价肿瘤血管生成的价值及可行性。方法对病理证实的22例肾癌患者进行CT灌注检查,计算血流量(BF)、血容量(BV)、平均通过时间(MTT)、毛细血管通透性(PS)的定量值,并得到各参数的灌注伪彩图。利用双标记免疫组织化学方法对肾癌标本进行CD34、α-SMA染色,以计算MVD和肿瘤VMI。结果BF和BV与MVD之间均存在明显的相关性,相关系数分别为BF:r=0.643,P=0.001;BV:r=0.542,P=0.012;各灌注参数与肿瘤VMI均未见明显的相关性。结论CT灌注成像可无创评价肾癌的肿瘤血管生成,但CT灌注参数不能反映肾癌肿瘤新生血管的成熟程度。

Objective To observe the correlation among the CT perfusion parameters, tumor microvessel density （MVD） and tumor vessel maturation indices （VMI） in the renal carcinoma, and to explore the feability and posibility of CT perfu- sion in assessing tumor neovascularity in renal cell carcinoma. Methods Twenty-two patients with histologically diagnosed renal cell carcinoma underwent CT perfusion. Blood flow （BF）, blood volume （BV）, mean transport time （MTT） and per- meability-surface area product （PS） were quantitatively calculated for all the lesions, and the transverse functional CT map imagine was obtained. A double-labeling immunohistochemical technique was used to stain CD34 and a-SMA, microvessel density （MVD） and tumor vessel maturation indices （VMI） were calculated. Results Positive correlation was found be- tween BF and MVD （r=0. 643）, BV and MVD （r=0. 542）, but no CT perfusion parameters significantly correlated with VMI. Conclusion CT perfusion may be suitable to evaluate tumor vascularity in vivo on the basis of the correlation be- tween perfusion parameters and MVD of renal cell carcinoma, but can not be used to access tumor vessel maturation level.