摘要
目的探讨多层螺旋 CT(MSCT)灌注成像在定量评价软组织恶性肿瘤介入治疗前后肿瘤血管生成和介入治疗后早期疗效监测中的应用价值。方法 24只成功种植 VX_2肿瘤的新西兰大白兔,数字表法随机分为介入组和对照组,每组12只,分别于肿瘤种植后第14天、介入治疗后第3天行常规 CT 平扫和灌注扫描,计算肿瘤组织和正常肌肉组织的血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)值,分析各参数之间的差异性;并将各灌注参数分别与肿瘤微血管密度(MVD)值和血管内皮生长因子(VEGF)平均吸光度(A)值进行相关性分析。结果肿瘤种植后第14天,介入组肿瘤 BF、BV、MTT、PS 值分别为(303.3±69.9)ml·100 g^(-1)·min^(-1)、(7.02±3.10)ml/100 g、(1.99±0.28)s、(65.9±9.4)ml·100 g^(-1)·min^(-1),与正常肌肉组织相比[分别为(11.8±5.0)ml·100 g^(-1)·min^(-1)、(1.04±0.47)ml/100 g、(17.92±7.19)s、(13.1±6.4)ml·100 g^(-1)·min^(-1)]差异有统计学意义(F 值分别为4285.82、1867.46、413.04、698.42,P<0.01);与对照组肿瘤的各参数值差异无统计学意义(F 值分别为2.47、2.03、0.02、0.53,P>0.05)。介入组肿瘤MVD 值和 VEGF 平均 A 值分别为(50.1±4.1)个/高倍视野、0.352±0.011,与对照组肿瘤[分别为(50.2±3.7)个/高倍视野、0.352±0.009]差异无统计学意义(F 值分别为0.02、0.19,P>0.05)。介入治疗后第3天(即种植后第18天),介入组肿瘤 BF、BV、MTT、PS、MVD 值和 VEGF 平均 A 值分别为(7.5±24)ml·100 g^(-1)·min^(-1)、(1.20±0.23)ml/100 g、(3.29±0.57)s、(4.0±1.5)ml·100 g^(-1)·min^(-1)、(16.0±2.4)个/高倍视野、0.215±0.008,与对照组相比[分别为(390.2±116.3)ml]·100 g^(-1)·min^(-1)、(8.47±2.53)ml/100 g、(1.88±0.34)s、(76.9±11.3)ml·100 g^(-1)·min^(-1)、(84.8±5.6)个/高倍视野、0.366±0.013]差异有统计学意义(F 值分别为10 166.91、1310.19、272.84、1649.80、1239.72、4168.91,P<0.01);与介入治疗前相比,差异也有统计学意义(t 值分别为74.53、49.62、-16.82、35.36、50.41、65.64,P<0.01)。肿瘤 BF、BV、PS 值与 MVD 值和 VEGF 平均A值呈正相关(r 值均>0.7,P<0.05);MTT 值与 VEGF 平均4值呈负相关(r=-0.78,P<0.05),而与肿瘤 MVD 值无明显相关性(r=-0.315,P>0.05)。结论 MSCT 灌注成像是一种定量评价肿瘤血管生成、血流灌注及血管通透性改变的功能成像方法,可以无创、准确地对肿瘤介入治疗早期疗效进行定量评价和动态监测。
Objective To investigate the applicative value of multi-slice CT （MSCT） perfusion imaging on quantitative assessment of tumor angiogenesis before and after interventional therapy and monitoring the early interventional therapeutic effect in malignant soft-tissue tumor. Methods Twenty-four New Zealand white rabbits successfully implanted VX2 tumor in the unilateral proximal thigh were divided into two groups （twelve per group） at random and performed conventional CT plain scan and perfusion scan 14 days after implantation and 3 days after interventional therapy respectively. The values of blood flow （BF） , blood valume （ BV ） , mean transit time （ MTT ） and premeability surface （ PS ） of VX2 tumors and normal muscular tissues were computed and the differences among them were analyzed. Meanwhile, correlative analysis between perfusion parameters and micro-vessel density（MVD） counts, average A value of vascular endothelial growth factor（VEGF） was done. Results Before interventional therapy, the values of BF, BV, MTY and PS of VX2 tumors in interventional group were （303. 3 ±69. 9） ml· 100 ^-1 ·min^-1 , （7.02±3.10） ml/100 g, （1.99 ±0.28） s and （65.9 ±9.4） ml · 100 g^-1·min^-1 respectively. Compared with the parametric values of normal muscular tissues, there were significant differences between them （F value was 4285.82, 1867.46, 413.04 and 698.42 respectively, P 〈 0. 01 ）. There were no significant differences of the above parametric values between interventional group and the control group （ F value was 2. 47, 2. 03, 0. 02 and 0. 53 respectively, P 〉 0. 05 ）. The values of MVD counts, average A value of VEGF of VX2 tumors in interventional group were 50. 1 ± 4. 1/HP and 0. 352 ± 0.011 respectively. There were no significant differences between interventional group and the control group （ F value was 0. 02 and 0. 19 respectively, P 〉0. 05 ）. Three days after interventional therapy, the values of BF, BV, MTT, PS, MVD and VEGF of VX2 tumors in interventional group were （7.5 ± 2. 4 ） ml ·100g^-1·min^-1 （1.20±0.23） ml/100 g, （3.29±0.57） s, （4.0±1.5） ml. 100 g^-1 ·min^-1 ,16.0 ± 2. 4/HP and 0. 215 ± 0. 008 respectively. Compared with the values of pre-interventional therapy and the control group, there were significant differences among them （ P 〈 0. 01 ）. Additionally, the values of BF, BV, PS in VX2 tumors had a significant positive correlation with MVD counts, average A value of VEGF （ r 〉 0. 7, P 〈 0.05 ）, however, the value of MTT had no significant correlation with MVD （ P 〉 0. 05 ） but had a significant negative correlation with average A value of VEGF （ r = - 0. 78, P 〈 0. 05 ）. Conclusion MSCT perfusion imaging is a functional imaging technique that is capable of quantitative assessment to tumor angiogenesis, blood perfusion and vascular permeability, which can evaluate the early interventional therapeutic effect in malignant soft-tissue tumor invasively and accurately.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第4期417-422,共6页
Chinese Journal of Radiology
基金
浙江省(卫生厅)医药卫生科学研究基金(2006B032)
关键词
体层摄影术
X线计算机
灌流
放射学
介入性
新生血管化
病理性
Tomography, X-ray computed
Perfusion
Radiology, interventional
Neovascularization, pathological
