CAJ | 학술논문

目的：探讨 T2*加权增强血管成像(enhanced T2 star weighted angiography,ESWAN)参数指标与脑神经胶质瘤微血管密度(microvessel density,MVD)、血管内皮生长因子(vascular endothelial growth factor,VEGF)间的相关性。方法对53例临床疑似脑胶质瘤患者行 ESWAN 检查,原始数据传至 ADW 4.3工作站,得到 ESWAN 最小密度投影图(minimum intensity projection,ESWANMinIP)、相位图(phase image,PI),分别测量肿瘤感兴趣区(ROI)及对侧正常脑白质的参数：R2*值、T2*值及 Phase 值；记录 ESWANMinIP 上肿瘤实质区出血灶及血管结构数目,并对其分级。病理标本免疫组织化学染色,测定 MVD 计数和 VEGF 表达,单因素方差分析脑胶质瘤与对侧正常脑白质 R2*值、T2*值及 Phase 值的差异性；应用 Spearman 相关性检验分析 MVD、VEGF 与 ESWAN 各参数指标的相关性；不同级别脑胶质瘤与瘤内出血及血管数目分级间的差异性采用 Kruskal-Wallis H 秩和检验。结果不同级别胶质瘤病灶 T2*、Phase 的平均值明显高于对侧正常脑白质,差异有统计学意义(P <0.05)；R2*的平均值也与正常脑白质差异有统计学意义(P <0.05)。感兴趣区内,T2*值与 MVD 呈负相关(r =-0.642,P <0.05),R2*值与 MVD 呈正相关(r =0.765,P <0.05),Phase 值与 MVD 呈正相关(r =0.811,P <0.01)；T2*值在 VEGF 阳性表达组(11.178±2.911)Ms,阴性组(23.263±2.383)Ms,差异具有统计学意义(P <0.01),R2*值在 VEGF 表达阳性组(12.611±1.967)Hz,阴性组(5.316±0.767)Hz,差异有统计学意义(P <0.01),Phase 值在 VEGF 表达阳性组(1.086±0.017)Radian,阴性组(1.386±0.021)Radian,差异无统计学意义(P >0.05)。除Ⅰ级与Ⅱ级、Ⅰ级与Ⅲ级间肿瘤内出血及血管成分差异无统计学意义外,余各组的两两比较差异均有统计学意义(P <0.01)。结论ESWAN 参数指标与脑胶质瘤 MVD、VEGF 相关,在非侵袭性评价脑胶质瘤血管生成方面有重要价值。
목적：탐토 T2*가권증강혈관성상(enhanced T2 star weighted angiography,ESWAN)삼수지표여뇌신경효질류미혈관밀도(microvessel density,MVD)、혈관내피생장인자(vascular endothelial growth factor,VEGF)간적상관성。방법대53례림상의사뇌효질류환자행 ESWAN 검사,원시수거전지 ADW 4.3공작참,득도 ESWAN 최소밀도투영도(minimum intensity projection,ESWANMinIP)、상위도(phase image,PI),분별측량종류감흥취구(ROI)급대측정상뇌백질적삼수：R2*치、T2*치급 Phase 치；기록 ESWANMinIP 상종류실질구출혈조급혈관결구수목,병대기분급。병리표본면역조직화학염색,측정 MVD 계수화 VEGF 표체,단인소방차분석뇌효질류여대측정상뇌백질 R2*치、T2*치급 Phase 치적차이성；응용 Spearman 상관성검험분석 MVD、VEGF 여 ESWAN 각삼수지표적상관성；불동급별뇌효질류여류내출혈급혈관수목분급간적차이성채용 Kruskal-Wallis H 질화검험。결과불동급별효질류병조 T2*、Phase 적평균치명현고우대측정상뇌백질,차이유통계학의의(P <0.05)；R2*적평균치야여정상뇌백질차이유통계학의의(P <0.05)。감흥취구내,T2*치여 MVD 정부상관(r =-0.642,P <0.05),R2*치여 MVD 정정상관(r =0.765,P <0.05),Phase 치여 MVD 정정상관(r =0.811,P <0.01)；T2*치재 VEGF 양성표체조(11.178±2.911)Ms,음성조(23.263±2.383)Ms,차이구유통계학의의(P <0.01),R2*치재 VEGF 표체양성조(12.611±1.967)Hz,음성조(5.316±0.767)Hz,차이유통계학의의(P <0.01),Phase 치재 VEGF 표체양성조(1.086±0.017)Radian,음성조(1.386±0.021)Radian,차이무통계학의의(P >0.05)。제Ⅰ급여Ⅱ급、Ⅰ급여Ⅲ급간종류내출혈급혈관성분차이무통계학의의외,여각조적량량비교차이균유통계학의의(P <0.01)。결론ESWAN 삼수지표여뇌효질류 MVD、VEGF 상관,재비침습성평개뇌효질류혈관생성방면유중요개치。
Objective To investigate the relationship between enhanced T2 star weighted angiography (ESWAN)parameter indexes and the microvessel density (MVD)and vascular endothelial growth factor (VEGF) glioma patients.Methods A total of 53 cases with suspected gliomas were examined by ESWAN.All raw data were transferred to ADW 4.3 workstation,the minium intensity projection (ESWANMinIP)and phase image (PI)were obtained.Tumor areas of interest return-on-investment (ROI)and contra lateral normal white matter of brain of parameters including R2* value,T2* value and phase value were calculated,respectively.The structures and number of the vessels were observed on ESWANMinIP,and its classification was recorded.Pathologic specimens were stained by immunohistochemistry,MVD count and VEGF expression were determinated.The difference in R2* value,T2*value and phase value between glioma and contra lateral normal white matter of brain were tested by one-way ANOVA test.Spearman correlation test was applied to analyze the correlation between MVD,VEGF and ESWAN of each parameter.Bleeding and classification of vessel number in different grade glioma were detected by Kruskal-Waltis H test.Results The average values in T2* and phase value were significantly higher in glioma than in the contra lateral normal white matter (P < 0.05 ).The average value in R2 * values between glioma and the contra lateral normal white matter had significant difference (P <0.05).In ROI,T2* values were negatively correlated with MVD (r =-0.642,P <0.05),R2* and phase values were positively correlated with MVD (r =0.765 and 0.81 1,P <0.05 and <0.01,respectively).The expression of VEGF in group T2* was significantly lower in the positive group than in the negative group (1 1.1 78±2.91 1)Ms vs (23.263±2.383)Ms(P <0.01).The expression of VEGF in group R2*was significantly higher in the positive group than in the negative group (12.61 1±1.967)Hz vs (5.31 6±0.767)Hz (P <0.01).Phase value showed no significant difference between the positive group and the negative group in group (P >0.05).There were no significant difference in intratumoral hemorrhage and vascular component among class Ⅰ and class Ⅱ,class Ⅰ and class Ⅲ,the others showed significant difference (P <0.01).Conclusion ESWAN parameter indexes were associated with MVD and VEGF in brain glioma,they had important value in the noninvasive evaluation of brain glioma angiogenesis.