肌骨肿瘤DSC-MR灌注参数与微血管生成的相关性研究

Correlation between DSC-MR Perfusion Parameters and MVD in Musculoskeletal Tumors

目的探讨动态增强磁化率对比(DSC)-MR灌注参数与肌骨肿瘤微血管密度(MVD)之间的相关性在评价肿瘤良恶性及生物学活性方面的价值。方法对68例原发性肌骨肿瘤(良性32例,恶性36例)术前行MRI常规及DSC-MR灌注成像检查,分别得到负性强化积分(NEI)、最大下降斜率(MSD)及平均通过时间(MTE)灌注参数;术后对肿瘤病理切片进行SP法免疫组织化学染色,检测肿瘤MVD,分别统计各灌注参数结果并分析其与MVD之间的相关性。结果良性肿瘤MVD为13.4±4.16,恶性肿瘤MVD为22.46±5.76,两者差异有统计学意义(t=7.344,P<0.01)。经相关分析得出NEI、MSD及MTE与MVD均有相关性,其中NEI、MSD呈显著正相关,r值分别为0.623、0.601,MTE与MVD呈低度线性相关,r值为0.274。结论 MR部分灌注参数与肿瘤微血管生成有显著相关性,提示动态磁敏感增强可以评价肿瘤血管化及血管生成情况,为临床术前及预后提供更为可靠的病理生理学信息。

Objective To investigate the correlation between DSC-MR perfusion parameters and musculoskeletal tumor micro-vessel density （MVD）, and to evaluate this correlation in diagnosing benign and malignant tumors as well as in as- sessing the biological activity of the tumor. Methods Sixty-eight cases with primary musculoskeletal tumors, including 32 benign tumors and 36 malignant tumors, were included in this study. Preoperative conventional 3.0 T MRI and DSC-MRI scan was performed in all patients. The negative reinforcement integral （NEI） , the maximum slope of decrease （MSD） and the mean time to enhance （MTE） were determined. After the operation, the pathological slices were stained with SP immu- nohistochemical method to estimate tumor＇s MVD. The perfusion parameters were analyzed, and correlation between the perfusion parameters and MVD was evaluated. Results （ 1 ） The MVD of the malignant tumors （22.46± 5.76） was sig- nificantly higher than that of the benign tumors （ 13.4 ± 4.16）. The difference was statistically significant. （2） Correlation analysis showed that a positive correlation existed between NEI, MSD, MTE and MVD, among which a statistically signifi- cant positive correlation existed between NEI, MSD and MVD （r = 0. 623 and r =0. 601 respectively） , while a weak linear correlation existed between MTE and MVD （ r = 0. 274）. Conclusion Several MR perfusion parameters carry significant ton＇elation with the tumor angiogenesis, indicating that dynamic susceptibility enhancement MRI can be used to evaluate the tumor vascularization and angiogenesis, which provides physicians with reliable pathophysiological information.