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目的:研究星形细胞瘤磁共振灌注成像与肿瘤血管内皮细胞生长因子及肿瘤血管形成的相关性,评价磁共振灌注成像在术前肿瘤血管形成的在体研究中的价值。方法:术前进行MRI成像检查且经手术病理证实的34例星形细胞瘤患者,其中Ⅰ~Ⅱ级(低分级)26例,Ⅲ~Ⅳ级(高分级)8例。运用自旋回波-回波平面成像(SE-EPI)技术行MR灌注成像。采用免疫组化方法(SP法)检测34例人脑星形细胞瘤血管内皮细胞生长因子(VEGF)表达;Ⅷ因子相关抗原单克隆抗体免疫组织化学(SP法)染色显示微血管,测量微血管密度(MVD)表示肿瘤血管生成。结果:34例星形细胞瘤最大rCBV与其对应的VEGF表达水平和对应的MVD呈显著正相关(r=0.604,P<0.001;r=0.625,P<0.001);高分级星形细胞瘤最大rCBV、VEGF表达和MVD显著高于低分级星形细胞瘤(t=3.0,7.08,3.37;P=0.017,0.01,0.011)。结论:磁共振灌注成像在术前活体研究星形细胞瘤的肿瘤血管形成及评价肿瘤的良恶性和预后中很有价值。
Objective: To study the correlation between magnetic resonance perfusion imaging of astrocytoma and tumor vascular endothelial growth factor and tumor angiogenesis, and to evaluate the value of magnetic resonance perfusion imaging in in vivo study of preoperative tumor angiogenesis. Methods: Thirty-four patients with astrocytoma who were examined by MRI and confirmed by surgery and pathology were enrolled in this study. There were 26 patients with grade Ⅰ ~ Ⅱ (grade Ⅰ) and 8 patients with grade Ⅲ ~ Ⅳ (grade Ⅲ). MR perfusion imaging was performed using spin echo-echo planar imaging (SE-EPI). Immunohistochemistry (SP method) was used to detect the expression of vascular endothelial growth factor (VEGF) in 34 cases of human astrocytoma; the monoclonal antibody of Ⅷ factor related antigen was immunohistochemically stained to show the microvessel and the microvessel density MVD) indicates tumor angiogenesis. Results: The maximum rCBV in 34 cases of astrocytoma was positively correlated with its corresponding VEGF expression level and corresponding MVD (r = 0.604, P <0.001; r = 0.625, P <0.001) , VEGF expression and MVD were significantly higher than low-grade astrocytoma (t = 3.0,7.08,3.37; P = 0.017,0.01,0.011). CONCLUSION: MR perfusion imaging is of great value in the study of the tumor angiogenesis of astrocytomas and the evaluation of benign and malignant tumors and prognosis of astrocytomas.