4D-THRIVE动态增强扫描评价早期宫颈癌微血管通透性的价值

Application of 4D-THRIVE Dynamic Contrast-Enhanced Scan in Evaluating Microvascular Permeability of Early Cervical Cancer

目的应用4D-THRIVE动态增强扫描磁共振成像技术,分析早期宫颈癌微血管通透性的特点及临床意义。方法对30例正常宫颈组、48例宫颈癌组(Ⅰ期16例均为宫颈鳞癌Ⅰb期,Ⅱ期32例包括宫颈鳞癌27例,宫颈腺癌5例)分别进行4D-THRIVE动态增强扫描,在Matlab平台下对兴趣区内STC及CTC进行非线性拟合获得血管通透性相关参数Ktrans,Kep及Ve值,评估正常宫颈组、宫颈癌组血管通透性的特点。结果正常宫颈组及宫颈癌组比较,Ktrans及Kep有显著性差异(P<0.05),Ve值差异无统计学意义;宫颈癌Ⅰ期组与宫颈癌Ⅱ期组比较,Ktrans及Kep有显著性差异(P<0.05),Ve值差异无统计学意义(P>0.05);同级别宫颈鳞癌组与宫颈腺癌组相比较,Ktrans及Kep有显著性差异(P<0.05),Ve值差异无统计学意义(P>0.05)。结论 4D-THRIVE动态增强定量分析宫颈癌微血管通透性有助于术前评估肿瘤的生物学行为,在宫颈癌血管的生成、对治疗的反应、对放疗和化疗的敏感性以及预后评价等方面提供一种无创性检查技术。

Objective To investigate the microvascular permeability characteristics of early cervical cancer by using4D-THRIVE dynamic contrast-enhanced magnetic resonance imaging scan,and to discuss its clinical significance. Methods A total of 30 patients with normal cervix（ normal cervix group） and 48 patients with cervical cancer（ cervical cancer group） were included in this study. Of the 48 patients with cervical cancer,stage I was seen in 16（ all were stage Ib cervical squamous cell carcinoma）,and stage II was seen in 32,including cervical squamous cell carcinoma（ n = 27） and cervical adenocarcinoma（ n = 5）. 4D-THRIVE dynamic contrast-enhanced MRI scan was performed in all patients. On the Matlab platform,STC and CTC in the region of interest（ ROI） were analyzed by non-linear fitting to obtain the permeability parameter-related K^trans,Kepand Vevalues,and the microvascular permeability characteristics of the normal cervix group and the cervical cancer group were evaluated. Results Statistically significant differences in K^transand Kepvalues existed between the normal cervix group and the cervical cancer group（ P〈0. 05）,while Vevalue had no statistical significance.Statistically significant differences in K^transand Kepvalues also existed between stage Ⅰ and stage Ⅱ cervical cancer（ P〈0. 05）,while Vevalue had no statistical significance（ P〉0. 05）. When the K^transand Kepvalues were compared between the cervical squamous cell carcinomas and the cervical adenocarcinomas of the same grade,the differences were statistically significant（ P〈0. 05）,while Vevalue had no statistical significance. Conclusion As a noninvasive technique,4DTHRIVE dynamic contrast-enhanced MRI scan can quantitatively analyze the microvascular permeability of cervical cancer,which is very helpful in making preoperative evaluation of the tumor＇s biological behavior,the cancer angiogenesis,the response to the treatment,and the sensitivity to radiotherapy and chemotherapy,and in predicting the prognosis as well.