肾细胞癌螺旋CT三期动态增强和MRI特征及其与肿瘤血管形成的相关性

Research on CT and MRI characteristics of renal cell carcinoma and correlation with tumor angiogenesis

目的探讨肾细胞癌CT和MRI特征及其与肿瘤血管形成的相关性。方法选择2010年3月至2013年3月间接受检查并经病理学确诊的肾细胞癌患者30例(研究组),另外选取10例因肾外伤等原因行肾脏手术的成年患者为对照组,采用螺旋CT三期动态增强检查和MRI三期增强检查,分析肾细胞癌患者的CT、MRI特征性影像表现。免疫组化检测肿瘤微血管密度(MVD)和血管内皮生长因子(VEGF),分析其与肿瘤血管形成的相关性。结果肾细胞癌组织的MVD和VEGF表达高于正常肾组织,且VEGF表达与肿瘤分期具有相关性。病灶中心CT的主要参数△Hu、TBR、斜率(S)、AR与病灶边缘的CT参数差异有统计学意义(P<0.05)。MRI各项参数中,病灶边缘与中心之间的MSI、SER、PEI、MSD及PV差异均有统计学意义(P<0.05)。结论肾细胞癌中心具有明显的三期动态增强CT和MRI特征,与肾细胞癌肿瘤血管具有一定的相关性,螺旋CT三期动态增强和MRI可以作为诊断肾细胞癌及判断肿瘤血管生成的方法。

Objective To investigate the renal cell carcinoma with CT and MRI characteristics and correlation of tumor angiogenesis. Methods 30 patients with renal cell carcinoma admitted to our hospital from March 2010 to March 2013 confirmed by pathology were selected. Imaging findings of CT and MRI were analyzed through three-phase dynamic spiral CT contrast-enhanced scan for CT and three-phase contrast-enhanced scan for MRI examination. Then relative study on tumor angiogenesis with the surgical removal of cancerous tissue cases was detected by immunohistochemistry. Results Cell carcinoma of the MVD and VEGF expression were higher than those of normal kidney tissue, and VEGF expression correlated with the stage. CT of the main parameters AHu,TBR,slope （S） ,AR in tumor center and the edge of the lesion on CT parameters were different. The differences of MRI parameters, the lesion edge and the center between the MSI, SER, PEI, MSD and PV were statistically significant （P 〈 0.05 ）. Conclusion Renal cell carcinoma has distinct characteristics of dynamic contrast-enhanced CT and MRI,witch has some correlation with renal cell carcinoma tumor blood vessels, therefore, three dynamic enhanced spiral CT and MRI can be used as diagnosis methods of renal cell carcinoma as much as tumor angiogenesis and judgment.