DCE-MRI直方图分析评估胶质瘤血管生成的价值

Value of Histogram Analysis of DCE-MRI in Estimating Glioma Angiogenesis

目的探讨动态对比增强磁共振成像(DCE-MRI)直方图分析在评估胶质瘤血管生成中的价值。方法搜集70例术前行DCE-MRI检查的胶质瘤患者,测量每例肿瘤实质的容积转运常数(K^(trans))以及血管外细胞外容积比(V_(e))的直方图参数。检测每例肿瘤的异柠檬酸脱氢酶1(IDH1)基因状态、CD105标记的微血管密度(CD105-MVD)以及血管内皮生长因子(VEGF)的表达情况。采用独立样本t检验或Mann-Whitney U检验分析不同IDH1分型胶质瘤的K^(trans)、V_(e)直方图参数及CD105-MVD的差异性,应用卡方检验分析VEGF表达的差异性;采用Person或者Spearman相关性检验分析K^(trans)、V_(e)的直方图参数与CD105-MVD、VEGF表达之间的相关性。P<0.05为差异具有统计学意义。结果IDH1突变型胶质瘤的K^(trans)、V_(e)直方图参数以及CD105-MVD、VEGF表达均低于IDH1野生型胶质瘤(P<0.05);在所有胶质瘤中,除了V_(e)第5百分位数之外,K^(trans)和V_(e)的直方图参数与CD105-MVD均呈正相关(P<0.05);在IDH1突变型胶质瘤中,除了K^(trans)第5百分位数和V_(e)第5、10、25百分位数之外,K^(trans)和V_(e)的直方图参数与CD105-MVD均呈正相关(P<0.05);在IDH1野生型胶质瘤中,除了V_(e)第5、10百分位数之外,K^(trans)和V_(e)的直方图参数与CD105-MVD均呈正相关(P<0.05)。在所有胶质瘤中,K^(trans)和V_(e)的直方图参数与VEGF表达均呈正相关(P<0.05);在IDH1突变型胶质瘤中,除了K^(trans)第5百分位数和V_(e)第5、10百分位数之外,K^(trans)和V_(e)的直方图参数与VEGF表达均呈正相关(P<0.05);在IDH1野生型胶质瘤中,除了V_(e)第5、10百分位数之外,K^(trans)和V_(e)的直方图参数与VEGF表达均呈正相关(P<0.05)。结论DCE-MRI直方图分析在评估胶质瘤血管生成中具有一定的临床参考价值。

Objective To explore the value of histogram analysis of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)in estimating glioma angiogenesis.Methods 70 glioma patients who underwent preoperative DCE-MRI examination were reviewed.Histogram parameters of volume transfer constant(K^(trans))and volume of extravascular extracellular space per unit volume of tissue(V_(e))were measured based on tumor parenchyma.Isocitrate dehydrogenase 1(IDH1)genotypes,CD105-microvascular density(CD105-MVD)and vascular endothelial growth factor(VEGF)expression of glioma samples were assessed by immunohistochemistry.The Independent Samples T test or Mann Whitney U test was used to analyze the differences in histogram parameters of K^(trans),V_(e)and CD105-MVD between different IDH1 genotypes gliomas.Chi-Square test was used to analyze the differences in VEGF expression.The Person test or Spearman test was used to analyze the correlation between histogram parameters of K^(trans),V_(e)and CD105-MVD,VEGF expression in gliomas.P<0.05 was considered statistically significant.Results All histogram parameters of K^(trans),V_(e)and CD105-MVD,VEGF expression in IDH1 mutation-type gliomas were lower than those in IDH1 wild-type gliomas(P<0.05).In all gliomas,histogram parameters of K^(trans)and V_(e)were positively correlated with CD105-MVD except 5th percentile of V_(e)(P<0.05);In IDH1 mutationtype gliomas,histogram parameters of K^(trans)and V_(e)were positively correlated with CD105-MVD except 5th percentile of K^(trans)and 5th,10th,25th percentiles of V_(e)(P<0.05);In IDH1 wild-type gliomas,histogram parameters of K^(trans)and V_(e)were positively correlated with CD105-MVD except 5th,10th percentiles of V_(e)(P<0.05).In all gliomas,histogram parameters of K^(trans)and V_(e)were positively correlated with VEGF expression(P<0.05);In IDH1 mutation-type gliomas,histogram parameters of K^(trans)and V_(e)were positively correlated with VEGF expression except 5th percentile of K^(trans)and 5th,10th percentiles of V_(e)(P<0.05);In IDH1 wild-type gliomas,histogram parameters of K^(trans)and V_(e)were positively correlated with VEGF expression except 5th,10th percentiles of V_(e)(P<0.05).Conclusion Histogram analysis of DCE-MRI plays a role in estimating glioma angiogenesis.