目的动态增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)为乳腺癌敏感度最高的检查方法之一,能够显示病灶血供情况而间接评价病灶微血管生成情况。探讨DCE-MRI半定量参数达峰时间(the time to peak enh...目的动态增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)为乳腺癌敏感度最高的检查方法之一,能够显示病灶血供情况而间接评价病灶微血管生成情况。探讨DCE-MRI半定量参数达峰时间(the time to peak enhancement,TTP)、早期增强率(early-phase enhancement rate,E1)、最大线性斜率(SLOPE)与乳腺癌不同分子亚型血管生成的相关性,及比较乳腺癌4种不同分子亚型血管生成的特点。方法收集山东省肿瘤医院2012-12-01-2015-03-31经手术确诊的103例乳腺癌患者,术前1周内行DCE-MRI扫描,记录上述参数,对切除病变行常规病理和免疫组化检查,根据免疫组化结果分为4种不同分子亚型,观察微血管密度(microvessel density,MVD)计数和血管内皮生长因子(vascular endothelialgrowth factor,VEGF)的表达,并将不同分子亚型DCE-MRI各项参数与免疫组化结果进行相关性分析。结果 4种不同分子亚型的各动态增强参数差异均无统计学意义;三阴型乳腺癌MVD值(79.47±49.79)明显高于Luminal B型(50.89±18.21),P=0.02;除Luminal A型与Luminal B型外,其他各亚型之间VEGF表达差异均有统计学意义,P<0.001;三阴型乳腺癌的MVD与DCE-MRI的关系最密切,r=0.55,P=0.015;MVD与EER、SLOPE呈正相关,r=0.859,P<0.001;与TTP呈负相关,r=-0.60,P=0.007。Luminal A型乳腺癌MVD与EER(r=0.71,P<0.001)和SLOPE呈正相关(r=0.51,P=0.001)。结论三阴型乳腺癌较两种Luminal表现为更丰富的血管生成,三阴型及Luminal A型MVD与DCE-MRI半定量参数EER、SLOPE存在一定的相关性。展开更多
Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess th...Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess thevalue of DCE-MRI in the differential diagnosis of these diseases.Methods： Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor （30 cases of each）received conventional MRI and DCE-MRI examination. The volume transfer constant （Ktrans）, rate constant （Kep）,extravascular extracellular volume fraction （Ve） and plasma volume fraction （Vp） of the diseased vertebral bodieswere measured on the perfusion parameter map, and the differences in these parameters between the patients werecompared.Results： For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinaltuberculosis, respectively, the Ktrans values （median ＋ quartile pitch） were 0.989±0.014, 0.720±0.011 and0.317±0.005 min-1; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1; the Ve values were0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; thecorresponding H values were 50.25 （for Ktrans）, 52.47 （for Kep）, 48.33 （for Ve） and 46.56 （for Vp）, and all differenceswere statistically significant （two-sided P〈0.05）.Conclusions： The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinalmetastatic tumor, brucellar spondylitis and spinal tuberculosis.展开更多
基金funded by the National Natural Science Foundation of China (No. 81460259)
文摘Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess thevalue of DCE-MRI in the differential diagnosis of these diseases.Methods： Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor （30 cases of each）received conventional MRI and DCE-MRI examination. The volume transfer constant （Ktrans）, rate constant （Kep）,extravascular extracellular volume fraction （Ve） and plasma volume fraction （Vp） of the diseased vertebral bodieswere measured on the perfusion parameter map, and the differences in these parameters between the patients werecompared.Results： For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinaltuberculosis, respectively, the Ktrans values （median ＋ quartile pitch） were 0.989±0.014, 0.720±0.011 and0.317±0.005 min-1; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1; the Ve values were0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; thecorresponding H values were 50.25 （for Ktrans）, 52.47 （for Kep）, 48.33 （for Ve） and 46.56 （for Vp）, and all differenceswere statistically significant （two-sided P〈0.05）.Conclusions： The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinalmetastatic tumor, brucellar spondylitis and spinal tuberculosis.
