超声造影时间-强度曲线与伽马拟合曲线对肝细胞癌的诊断价值

Objective To investigate the value and the enhanced mode of time-intensity curve(TIC)combined with gamma curve of contrast-enhanced ultrasound in diagnosis of hepatocellular carcinoma.Methods The ultrasonic contrast images of 34 patients with hepatocellular carcinoma by the gamma curve were obtained by the time before,increased branch slope parameter, curve sharpness, gamma modulus, peak time,peak intensity, the average pre-peak intensity, increased branch slope and pre-peak area.Results Compared with the peripheral hepatic parenchyma, the curve of the tumor tissue ascended as well as declined more rapidly, peaked earlier with a more intensive peak value.There were significant differences between the two groups in all the data mentioned-above (P＜0.05 ).Conclusions TIC and gamma fit quantitative analysis can reflect the different perfusion characteristics between hepatocellular carcinoma and normal hepatic parenchyma objectively and accurately,so as to provide the quantitative criterion and basis for the diagnosis and hemodynamic study of the hepatocellular carcinoma.     

超声造影时间-强度曲线与伽马拟合曲线对肝细胞癌的诊断价值

Objective To investigate the value and the enhanced mode of time-intensity curve(TIC)combined with gamma curve of contrast-enhanced ultrasound in diagnosis of hepatocellular carcinoma.Methods The ultrasonic contrast images of 34 patients with hepatocellular carcinoma by the gamma curve were obtained by the time before,increased branch slope parameter, curve sharpness, gamma modulus, peak time,peak intensity, the average pre-peak intensity, increased branch slope and pre-peak area.Results Compared with the peripheral hepatic parenchyma, the curve of the tumor tissue ascended as well as declined more rapidly, peaked earlier with a more intensive peak value.There were significant differences between the two groups in all the data mentioned-above (P＜0.05 ).Conclusions TIC and gamma fit quantitative analysis can reflect the different perfusion characteristics between hepatocellular carcinoma and normal hepatic parenchyma objectively and accurately,so as to provide the quantitative criterion and basis for the diagnosis and hemodynamic study of the hepatocellular carcinoma.     

肝细胞癌的超声造影定量参数与肿瘤内新生动脉的相关性研究

目的 探讨肝细胞癌(hepatocellular carcinoma,HCC)的超声造影(contrast-ehhanced ultrasonography,CEUS)定量参数与HCC内新生动脉的关系.方法 对115例HCC的CEUS图像进行脱机分析和免疫组化染色,获得感兴趣区的灌注曲线及CEUS定量参数:峰值强度(maximum of intensity,IMAX)、上升时间(rise time,RT)、达峰时间(time to peak,TTP)、平均渡越时间(mean trasit time corresponding to the center of grayity,mTT)、上升斜率(rise slope,RS)和始消时间(washout time,WT).获得82例HCC内的非成对动脉数,将CEUS定量参数和非成对动脉数进行统计学分析.结果 HCC中非成对动脉数与RT、TTP、RS呈中度相关,r分别为-0.446,-0.432,0.431(P＜0.05),与IMAX和WT呈弱相关,r分别为0.303和0.285(P＜0.05).结论 HCC内的新生动脉是HCC动脉相增强的病理生理基础,CEUS定量参数反映了肿瘤灌注情况,与HCC中的非成对动脉数有关.

Abstract：

Objective To explore the relationships between the quantitative parameters for contrastenhanced ultrasonography(CEUS) in hepatocellular carcinoma (HCC) and arteries in neoangiogenesis.Methods One hundred and fifteen HCCs in CEUS were analyzed off-line with dynamic vascular curve of ImageArena and immunohistochemical stained in the tissue slices.Parameters including maximum of intensity(IMAX),rise time(RT),time to peak(TTP),mean trasit time corresponding to the center of gravity(mTT) ,rise slope(RS) and washout time(WT) were analyzed by statistics.Unpaired arteries(UAs)of 82 HCC cases were succesfully stained.Results The number of UAs had moderate correlation with RT (r = - 0.446),TTP (r = - 0.432) and RS (r = 0.431) (P ＜ 0.05),and it had mild correlation with IMAX (r = 0.303) ,WT (r = 0.285) (P ＜0.05).Conclusions Neoangiogenesis is a functional adaptation to altered vascular dynamics.Quantitative parameters of CEUS,reflecting hemodynamics of tumors,are correlated with UAs.     

肝细胞肝癌超声造影评估血管生成的初步研究

目的 研究肝细胞肝癌(HCC)的超声造影定量参数与其组织中的血管内皮生长因子(VEGF)表达及微血管密度(MVD)的相关性,探讨超声造影无创评价HCC血管生成的价值. 方法 选用Sequoia512超声诊断仪及造影剂SonoVue对28个HCC病灶行超声造影检查,脱机应用新型超声造影定量分析软件(SW-UCS)获得肿瘤内感兴趣区(ROI)的时间强度曲线(TIC)和灌注定量参数.肿瘤病理切片分别行CD34和VEGF免疫组织化学染色,测得MVD及VEGF表达.分析比较超声造影定量参数与VEGF表达及MVD的相关性. 结果 VEGF表达阳性组的HCC的峰值强度(PI)、强度增量(ISI)及曲线下面积(AUC)高于VEGF表达阴性组,差异有统计学意义(P＜0.05).VEGF表达阳性组及阴性组的HCC的MVD分别为(55.37±9.26)个/400倍视野、(36.67±8.57)个/400倍视野,差异有统计学意义(P＜0.05). 结论 HCC的超声造影定量参数与VEGF、MVD有一定的相关性,能无创地评估活体内HCC的血管生成.     

脑胶质瘤超声造影定量参数与微血管密度的相关研究

目的 探讨术中超声造影在评价不同病理级别脑胶质瘤血管生成变化中的应用价值.方法 对33例脑胶质瘤患者行超声造影检查,实时观察肿瘤血流灌注情况及增强特点,绘制时间-强度曲线获取定量指标.术后对切除的病灶行常规病理检查和免疫组织化学检测,记录肿瘤的微血管密度,定量分析不同级别脑胶质瘤血流灌注指标与术后病理微血管密度的相关性.结果 低级别和高级别脑胶质瘤的造影达峰时间和微血管密度值比较差异均有统计学意义(P=0.0001);不同分化程度的脑胶质瘤超声造影达峰时间与微血管密度之间呈负相关关系(r=-0.79,P=0.0001).结论 术中超声造影可以实时动态地观察微血管的灌注情况,超声造影可提示肿瘤内微血管密度,有助于术者准确判定脑胶质瘤病理分级,指导肿瘤的手术切除.

Abstract：

Objective To investigate the value of intraoperative contrast-enhanced ultrasound(CEUS) in evaluating pathological grades of cerebral gliomas. Methods Intraoperative CEUS was performed in 33 patients of cerebral gliomas of different pathological grades. Real-time blood perfusion and enhance characteristics of these tumors were observed,quantitative parameters from the automatically derived time-intensity curve (TIC) were obtained, and compared with the tumor microvessel density (MVD) by immunostaining with anti-CD34. Results The time to peak was significantly shorter and the MVD was significantly higher in the high grade cerebral gliomas compared with the low grade ones ( P <0. 05). The time to peak was negatively correlated with the MVD by immunostaining (r = -0.79, P < 0. 05). Conclusions Intraoperative CEUS could be used to observe microvascular perfusion in real-time, and could indirectly reflect the information of MVD in cerebral gliomas, which is of help to grade cerebral gliomas and guide surgical resections.     

Value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in papillary thyroid carcinoma

BACKGROUND Cervical lymph node metastasis in papillary thyroid carcinoma(PTC) affects the treatment and prognosis of patients. Ultrasound is a common imaging method for detecting cervical lymph nodes in PTC patients; however, it is not accurate in determining lymph node metastasis.AIM To evaluate the value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in PTC.METHODS A total of 94 patients with PTC were recruited. According to pathological results,lymph nodes were divided into two groups: metastatic group(n = 50) and reactive group(n = 63). The routine ultrasound findings, contrast-enhanced ultrasound and elastography data were recorded and compared. Logistic regression was used to generate predictive probability distributions for the diagnosis of lymph node metastasis with different indicators. Receiver operating characteristic curve analysis was used to test the efficacy of contrast-enhanced ultrasound combined with elastography based on routine ultrasound in evaluating PTC cervical lymph node metastasis.RESULTS The ratio of long diameter/short diameter(L/S) ≤ 2, irregular marginal morphology, missing lymphatic portal, peripheral or mixed blood flow distribution, peak intensity(PI), non-uniform contrast distribution and elasticity score in the metastatic group were significantly higher than those in the reactive group(P < 0.05). L/S ratio, missing lymphatic portal, PI and elasticity score had a significant influence on the occurrence of PTC cervical lymph node metastasis(P< 0.05). Furthermore, the area under the curve(AUC) for lymph node metastasis diagnosed using the combination of PI ratio, elasticity score, missing lymphatic portal and LS was 0.936, which was significantly higher than the AUC for PI ratio alone. The difference was statistically significant(P < 0.05). The fitting equation for the combined diagnosis was logit(P) =-12.341 + 1.482 × L/S ratio + 3.529 ×missing lymphatic portal + 0.392 × PI + 3.288 × elasticity score.CONCLUSION Based on the gray-scale ultrasound, the combination of contrast-enhanced ultrasound and elastography can accurately assess PTC cervical lymph node metastasis.     

时间-强度量化分析与原发性肝癌预后的初步研究

目的 探讨超声造影时间-强度量化分析与临床病理因素的关系,分析其在HCC患者预后中的作用.方法 73例HCC超声造影结果进行时间-强度量化分析;探讨超声造影时间-强度量化分析和血管内皮生长因子(VEGF)表达、微血管密度(MVD)以及临床病理因素之间的关系;探讨超声造影时间-强度量化分析判断HCC预后的作用.结果 37例HCC组织中VEGF呈阳性表达(50.7％).MVD与VEGF表达具有显著相关性(P＜0.05).VEGF阳性表达组中增强时间、消退时间及曲线下面积与阴性表达组间有显著性意义(P＜0.05).超声造影时间-强度分析参数与肿瘤大小无关(P＞0.05),而汇管区癌栓组超声造影增强时间与汇管区无癌栓组间有显著性意义(P＜0.05).肿瘤大小、VEGF阳性表达、汇管区癌栓与3年复发率和生存率有关.结论 超声造影可帮助临床明确病变性质,时间-强度量化分析结合临床病理因素可作为判断预后的重要参考.     

肝细胞癌的超声造影定量参数与肿瘤内新生动脉的相关性研究

Objective To explore the relationships between the quantitative parameters for contrastenhanced ultrasonography(CEUS) in hepatocellular carcinoma (HCC) and arteries in neoangiogenesis.Methods One hundred and fifteen HCCs in CEUS were analyzed off-line with dynamic vascular curve of ImageArena and immunohistochemical stained in the tissue slices.Parameters including maximum of intensity(IMAX),rise time(RT),time to peak(TTP),mean trasit time corresponding to the center of gravity(mTT) ,rise slope(RS) and washout time(WT) were analyzed by statistics.Unpaired arteries(UAs)of 82 HCC cases were succesfully stained.Results The number of UAs had moderate correlation with RT (r = - 0.446),TTP (r = - 0.432) and RS (r = 0.431) (P ＜ 0.05),and it had mild correlation with IMAX (r = 0.303) ,WT (r = 0.285) (P ＜0.05).Conclusions Neoangiogenesis is a functional adaptation to altered vascular dynamics.Quantitative parameters of CEUS,reflecting hemodynamics of tumors,are correlated with UAs.     

超声爆破微泡介导内皮抑素基因抑制兔颈动脉粥样硬化的实验研究

目的 探讨利用超声爆破微泡介导内皮抑素(endostatin,ES)基因转染对兔颈动脉粥样硬化斑块内新生血管及斑块生长的抑制作用.方法 20只颈动脉粥样硬化模型兔随机分为三组:A组,微泡+超声;B组,对照质粒+微泡+超声;C组,ES质粒+微泡+超声.建模2周行超声爆破微泡介导基因转染,间隔3周时重复转染1次.建模14周时行超声及数字减影血管造影(DSA)检查,病理检测病变血管新生内膜、斑块内新生血管及ES表达情况.结果 超声显示A组和B组内膜明显增厚,斑块较大,管腔明显狭窄,收缩期峰值流速(PSV)增加,C组上述指标明显较A组和B组低(P＜0.05).病理检测C组内中膜厚度(IMT)、内膜厚度(IT)、内中膜厚度比(IT/MT)、内膜面积(IA)、内中膜面积比(IA/MA)及新生内膜狭窄率与A组和B组比较差异均有统计学意义(P＜0.05).C组颈动脉新生血管及血管内皮生长因子(VEGF)表达均较A组和B组低,内膜及胫前肌可见较多ES表达,而A组和B组无明显ES表达.结论 一定超声辐照条件下,超声爆破微泡介导ES基因转染可抑制兔颈动脉粥样硬化病变的发展,有可能为动脉粥样硬化性疾病的基因治疗提供一种安全有效的方法 .

Abstract：

Objective To explore the inhibition effect on angiogenesis and plaque growth of carotid atherosclerosis by transfection of endostatin gene using microbubbles combined with ultrasound exposure.Methods Twenty rabbit models of carotid atherosclerosis were randomly divided into 3 groups:group A,microbubble+ ultrasound; group B, control plasmid + microbubble + ultrsound; group C, ES plasmid +microbubble+ ultrasound. Two weeks after surgery, ultrasound/microbubble mediated gene transfer was performed,and it was performed once again three weeks after the first transfection. Ultrasonography and digital subtraction angiography(DSA) were performed at the time of 14 weeks. The carotid arteries were taken to detect the neointima and angiogenesis, and the expression of endostatin was detected using pathological means. Results The imagings of ultrasound showed that the intima in group A and B were thick significantly with larger plaques, and the lumen became stenosis with the peak systolic velocity increasing,however,in group C,the parameters mentioned above were significantly less than those of group A and B ( P＜0.05). Pathological results displayed that intima-media thickness (IMT), intima thickness (IT), intima thickness/media thickness (IT/MT), intima area (IA), intima area/media area (IA/MA) and neointimal stenosis rates were greater in group A and B, however, they were less in group C ( P＜0.05).The number of neovascularization and vascular endothelial growth factor(VEGF) expression in group A and B were more than those of group C. There was more endostatin positive expression in carotid arteries and anterior tibial muscles of group C, while there was nearly no expression in group A and B. Conclusions Under the conditioned ultrasonic irradiation, ultrasound/microbubble mediated endostatin gene transfection can inhibit the development of carotid atherosclerosis in rabbits, which might provide a safe and effective strategy for gene therapy of atherosclerotic disease in future.     

靶向超声造影评价裸鼠肾癌新生血管的实验研究

目的 探讨以血管内皮生长因子受体2 (VEGFR2)为靶点的靶向超声造影评价裸鼠肾癌新生血管的应用价值.方法 建立人肾透明细胞癌皮下移植瘤裸鼠模型,制备携VEGFR2抗体的靶向造影剂(MBV),每只裸鼠分别随机注射普通造影剂(MBC)和MBV并行超声造影检查,比较两种造影剂的视频强度,并对肿瘤组织行VEGFR2免疫组化检测.结果 超声造影示MBV组视频强度(6.50±1.43)Db,MBC组视频强度(2.59±0.99)Db,两者差异有统计学意义(P<0.01),且MBV组持续强化时间较MBC组长,免疫组化结果证实肿瘤血管内皮VEGFR2高表达.结论 以VEGFR2为靶点的靶向造影剂可特异性增强肾癌显影,对评估肿瘤新生血管有重要价值.

Abstract：

Objective To investigate the value of contrast enhanced ultrasound(CEUS) with microbubbles targeted to vascular endothelial growth factor receptor type 2 (VEGFR2) for imaging tumor angiogenesis in murine tumor models.Methods Established human renal cell carcinomas(RCC) subcutaneous xenograft tumor model in nude mice,microbubbles targeted to VEGFR2(MBV) was prepared,control microbubbles(MBC) and MBV were injected respectively in each mouse,the intensity of each microbubble was compared,the expressions of VEGFR2 in tumors were tested by immunohistochemistry.Results CEUS imaging showed the intensity of MBV and MBC was (6.50±1.43)dB,(2.59±0.99)dB,respectively.There was significantly higher intensity when using MBV compared with MBC (P<0.01).The time to wash out was longer in MBV contrast group compared with MBC group.Immunohistochemistry showed VEGFR2 was highly expressed in novel vessel walls.Conclusions Contrast microbubbles targeted to VEGFR2 can specially enhance the images of RCC and has tremendous significance in the assessment of angiogenesis.     

肝细胞癌的超声造影定量灌注参数与MVD、VEGF表达的关系

目的 探讨肝细胞癌(HCC)超声造影(CEUS)定量灌注参数与微血管密度(microvessel density,MVD)、血管内皮生长因子(vascular endothelia growth factor,VEGF)表达的关系.方法 对45例HCC术前行CEUS,并脱机行时间-强度曲线(time-intensity curves,TIC)分析.术后标本行免疫组织化学技术检测MVD及VEGF表达,与定量灌注参数进行对比分析.结果 MVD以中位数20分为高MVD和低MVD组,两组间CEUS的TIC参数中的峰值强度(Peak)有统计学意义(P<0.01);MVD与Peak呈低度正相关(r=0.464,P<0.01),但与达峰时间(TP)、曲线尖度(Sharpness)和曲线下面积(AUC)相关分析无统计学意义(P>0.05);HCC不同VEGF表达的TIC参数间无明显等级相关(P>0.05),但与MVD呈正相关(r=0.621,P<0.001).结论 HCC的CEUS定量参数Peak与肿瘤MVD有相关性.VEGF表达与MVD存在正相关,可能间接影响造影表现.     

Correlation of real-time gray scale contrast-enhanced ultrasonography with microvessel density and vascular endothelial growth factor expression for assessment of angiogenesis in breast lesions.

OBJECTIVE: The purpose of this study was to determine the correlation of real-time gray scale contrast-enhanced ultrasonographic (CEUS) patterns and parameters with microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression for assessment of angiogenesis in breast lesions. METHODS: Real-time gray scale CEUS was performed in 53 women with breast lesions. Contrast-enhanced ultrasonographic patterns and quantitative parameters were analyzed. Mean MVD and VEGF expression in breast lesions were measured by immunohistochemical analysis. RESULTS: Surgical pathologic analysis showed 25 benign and 28 malignant lesions. Different CEUS patterns were observed in the high- and low-MVD and -VEGF groups. Microvessel density and VEGF expression were significantly associated with heterogeneous enhancement with or without perfusion defects and radial or penetrating vessels surrounding the lesions (P< .05). The enhancement order and degree were significantly related to MVD (P< .01) but not correlated with VEGF expression (P> .05). Malignant and benign lesions did not differ significantly in time-intensity parameters (P> .05). The peak intensity, rise in intensity, maximum rise slope of the curve, wash-out slope of the curve, and area under the time-intensity curve (area) were statistically correlated with MVD (P< .05). The highest correlation (r=0.56; P< .001), however, was between the area and MVD. No significant association was found between any CEUS parameters and VEGF expression (P> .05). CONCLUSIONS: Contrast-enhanced ultrasonographic patterns and parameters of breast lesions are more closely correlated with MVD than VEGF expression. Real-time gray scale CEUS has a potential role in evaluating angiogenesis in breast lesions, but CEUS parameters are not correlated with the malignancy or benignity of breast tumors.     

原发性肝细胞癌超声造影表现与微血管密度的相关性

目的 探讨原发性肝细胞癌(HCC)的造影增强时间-强度曲线参数与肿瘤微血管密度(MVD)的相关性. 方法 回顾性分析经病理证实为HCC的24例患者HCC超声造影增强时间-强度曲线参数(增强时间、上升斜率、相对峰值强度、峰值增强率、下降斜率),同时检测肿瘤的MVD,分析造影增强时间-强度曲线参数与MVD的相关性. 结果 中低分化HCC组MVD大于高分化HCC组(P<0.05).HCC的相对峰值强度、下降斜率与MVD计数相关(P<0.05),相关系数分别为0.44、0.50. 结论 HCC造影增强时间-强度曲线的相对峰值强度、下降斜率可反映肿瘤微血管形成,不同分化程度HCC的MVD差异显著.     

高强度聚焦超声对兔肝肿瘤微血管密度及血管内皮细胞生长因子的影响

目的 探讨高强度聚焦超声(HIFU)对兔肝肿瘤模型的肿瘤微血管密度(mircrovessel density,MVD)、血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)的影响.方法用30只新西兰白兔制成VX2细胞肝癌模型,分为对照组(5只)和HIFU消融组(25只),于术后即时、1 d、3 d、7 d、16 d取材,用免疫组织化学SABC法观察并测晕肿瘤组织的MVD和VEGF的表达.结果 HIFU消融后,肿瘤组织MVD和VEGF的表达较术前明显降低(P＜0.01),但HIFU消融组内不同时间点间MVD及VEGF差异无统计学意义(P＞0.05).结论 HIFU消融可有效地破坏肿瘤组织的微血管,抑制血管形成并减少肿瘤组织的血供.     

原发性肝细胞癌的超声造影表现与血管内皮生长因子表达的相关性

目的探讨原发性肝细胞癌(HCC)的CEUS增强时间-强度曲线各参数与血管内皮生长因子(VEGF)表达的相关性。方法选择经手术病理证实的27例原发性HCC作为研究对象,其中中低分化癌16例,高分化癌11例,取其中13例患者的癌周组织作为对照。分析术前CEUS图像,绘制时间-强度曲线,计算增强时间、上升斜率、相对峰值强度、峰值增强率、下降斜率。应用S-P免疫组化法对VEGF进行定位,应用蛋白印迹法对VEGF进行定量,分析CEUS曲线参数与VEGF表达的相关性。结果 VEGF蛋白主要分布于胞浆中,蛋白定量分析显示中低分化HCC、高分化HCC、对照组织的VEGF蛋白相对含量分别为(46.63±9.70)%、(32.36±8.56)%、(8.85±5.05)%,两两比较差异均有统计学意义(P均<0.05)。HCC曲线的相对峰值强度与VEGF蛋白相对含量呈正相关(r=0.56,P<0.05),而增强时间、上升斜率、峰值增强率及下降斜率与VEGF蛋白相对含量均无相关性(P均>0.05)。结论 HCC造影增强时间-强度曲线的相对峰值强度可反映VEGF蛋白表达,不同分化程度HCC的VEGF蛋白相对含量差异显著。     

乳腺动态增强MRI参数与肿瘤血管的相关性及其鉴别诊断价值

目的探讨乳腺动态增强（DCE）MRI的各项参数：时间-信号强度曲线（TIC）、早期增强率（EER）、最大线性斜率（slope）、最大强化率（Slmax）、达峰时间（Tpeak）、MIP图血管计数（NTV）与微血管密度（MVD）、血管内皮生长因子（VEGF）之间的相关性及其对乳腺良、恶性病变的鉴别价值。方法对52例确定一周内手术治疗的乳腺疾病患者行术前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,观察边缘MVD（mMVD）、中心MVD（cMVD）和VEGF的表达。将DCE-MRI各项参数与免疫组化结果进行相关性分析。结果乳腺病变的mMVD、VEGF表达与TIC类型、Tpeak、及NTV育相关性;其中TIC类型与mMVD关系最为密切,Tpeak与VEGF之间的关系最密切;cMVD与各参数间无明显线性关系。52例患者中乳腺癌22例,良性病变30例。恶性病变的TIC呈Ⅲ或Ⅱ型,EER、NTV和DMVD、VEGF的表达明显高于良性病变,而Tpeak及SImax显著低于良性病变（P〈0．005）。Slope在良、恶性病变中无显著性差异。结论乳腺DCE—MRI多项参数中,TIC类型、NTV、Tpeak与MVD和VEGF有相关性,反映了良、恶性病变的血管生长差异,具有很大的鉴别诊断价值。     

彩色多普勒检测子宫内膜癌血流及其与MVD和VEGF表达的研究

目的 :探讨彩色多普勒检测子宫内膜癌血流及其与微血管密度 (MVD)和血管内皮生长因子(VEGF)表达的关系。方法 :采用经阴道彩色多普勒超声检测 46例子宫内膜癌肿瘤内血流信号 ,计测阻力指数(RI) ;采用免疫组织化学技术检测肿瘤 MVD及 VEGF表达。结果 :肿瘤内血流 RI值和 MVD与手术分期有关 ,而与组织学分级、肌层浸润深度、组织学类型无相关性。VEGF阳性表达率与组织学分级有关。RI值与 MVD呈负相关 (r=- 0 .2 87,P<0 .0 5) ;VEGF表达阳性者 MVD高于 VEGF表达阴性者。 VEGF表达阳性与表达阴性者之间 RI值无显著差异。结论 :上述三项指标可从不同角度反映子宫内膜癌的血管生成特征 ,彩色多普勒超声有助于对子宫内膜癌血管生成和预后的评价     

肝细胞肝癌超声造影与微血管密度的相关性研究

目的 探讨肝细胞肝癌(HCC)的超声造影定量参数与其组织中微血管密度(MVD)的相关性,探讨超声造影无创评价HCC血管生成的价值.方法 应用Sequoia 512超声诊断仪及造影剂SonoVue对28个HCC病灶行超声造影检查,脱机应用新型超声造影定量分析软件(SW-UCS)获得肿瘤及同深度癌旁肝实质的感兴趣区的时间强度曲线(TIC)和灌注定量参数.术后病理切片行CD34免疫组织化学染色并测得MVD.分析比较超声造影定量参数与MVD的相关性.结果 HCC与肝实质TIC曲线可以直观反映HCC相对于肝实质"快进快出"的典型增强表现.两者曲线上升速率(a3)、达峰时间(TTP)、峰值强度(PI)、强度增量(ISI)、加速时间(AcT)差异有统计学意义(P＜0.05).HCC的MVD(49.36±12.57)明显高于癌旁肝实质(32.46±11.78).两者差异有统计学意义(P=0.000).HCC的PI、ISI、曲线下面积(AUC)与MVD呈正相关,峰值减半斜率(a2)与MVD呈负相关(P＜0.05).结论 HCC的超声造影定量参数与MVD有一定的相关性,能无创地评估活体内HCC的血管生成.     

动态增强MRI评价肺癌肿瘤血管生成

目的评价动态增强磁共振成像(DCE-MRI)的各种强化参数与肺癌组织标本中肿瘤血管生成的相关性。方法对经手术病理证实的周围型肺癌患者14例行DCE-MRI检查,描绘时间-信号强度曲线,测量各强化参数,包括早期强化峰值(SIep)、强化峰值(SImax)、最大强化比(MER)和最大下降率(washout)。对肿瘤组织取材进行CD34和VEGF的免疫组织化学染色,分析各强化参数与肺癌组织标本的MVD和VEGF的相关性。结果 SIep、SImax与肺癌组织标本的MVD呈正相关(r=0.811、0.841,P均<0.01);而SIep、SImax、MER和最大下降率与VEGF均无相关性(P均>0.05)。结论应用SIep和SImax可预测肺癌组织标本的MVD水平,但根据DCE-MRI各强化参数均无法预测VEGF表达水平。     

乳腺癌超声造影与微血管密度的相关性研究

目的探讨乳腺癌微血管密度(MVD)与造影时间-强度曲线各参数之间的相关性,以及在鉴别乳腺肿瘤良恶性中的临床应用价值。方法对74例78个乳腺肿瘤行超声造影检查,利用时间-强度曲线进行评估,并结合CD34标记的MVD特征,研究二者相关关系及超声造影对乳腺癌的诊断价值。结果乳腺癌组MVD与峰值强度差值呈正相关(r=0.497,P<0.01),与峰值强度呈正相关(r=0.857,P<0.01),与上升及下降斜率、达峰时间无相关关系;乳腺良性肿瘤组MVD与上述时间-强度曲线定量指标参数间均未见明显相关。乳腺癌组MVD、峰值强度、峰值强度差值、上升斜率、下降斜率均高于良性组(P<0.05)。乳腺癌组与乳腺良性肿瘤组间起始强化时间、达峰时间、峰值持续时间比较差异无统计学意义(P>0.05)。结论超声造影微血管成像技术可以评估乳腺肿瘤MVD情况,可提高对乳腺肿瘤良恶性的鉴别诊断能力。