动态MRI定量分析支气管动脉灌注治疗对中央型支气管肺癌肿瘤血管生成的影响

目的　探讨动态MRI扫描评价BAI治疗对中央型支气管肺癌肿瘤血管生成影响的价值。方法　 2 0例中央型支气管肺癌 ,BAI疗前、疗后近期均行动态增强MRI扫描 ,绘制时间 信号强度曲线 ,测量和计算峰值、最大强化值、最大强化比值、最大斜率等各种参数 ,并与肿瘤微血管密度 (MVD)及血管内皮生长因子 (VEGF)的表达及其变化进行比较。结果　BAI治疗前后中央型支气管肺癌时间 信号强度曲线的峰值分别为 880 .5 5± 15 3 .0 4,80 8.2 5± 12 0 .2 6(P <0 .0 5 ) ;最大强化值分别为 40 0 .70± 99.82 ,3 3 6.2 5± 13 9.70 (P =0 .0 5 ) ;最大强化比值分别为 1.86± 0 .2 6,1.78± 0 .3 3 (P >0 .0 5 ) ;最大斜率分别为 2 2 .3 9± 8.18,2 0 .5 2± 9.13 (P >0 .0 5 )。BAI治疗前、后肿瘤组织MVD分别为 15 .91± 10 .73、2 3 .86± 7.77(P =0 .2 67) ;BAI治疗后肿瘤组织VEGF的表达明显下降 (P <0 .0 5 )。BAI治疗后VEGF表达与最大强化值和最大斜率呈负相关 (P <0 .0 5 ) ,其余各参数及其BAI治疗前后的变化均与MVD和VEGF无相关性。结论　动态增强MRI的部分参数可以用来定量分析BAI治疗对中央型支气管肺癌微循环的影响 ,但其与MVD及VEGF无明显的相关性。

Effect of BAI Therapy on Tumor Angiogenesis of Central Bronchogenic Carcinoma with Dynamic MRI Quantitative Analysis

Objective To evaluate the effects of BAI therapy on the tumor angiogenesis of central bronchogenic carcinoma with dynamic MRI. Methods Dynamic MRI was performed shortly before and after BAI therapy in 20 patients with central bronchogenic carcinoma. Time-intensity curves (TIC) were charted. Some parameters, such as peak intensity, maximum enhancement value, maximum enhancement ratio, the steepest slope, etc. were measured and calculated. MVD and VEGF protein expression of tumor tissue were measured respectively and those data were statistically analysed. Results Peak intensity of TIC before and after BAI therapy was 880.55±153.04 and 808.25±120.26 (P<0.05), maximum enhancement values 400.70±99.82 and 336.25±139.70 (P=0.05), maximum enhancement ratio 1.86±0.26 and 1.78±0.33 (P>0.05), and the steepest slopes 22.39±8.18 and 20.52±9.13 (P>0.05) respectively. MVD of tumor tissue before and after BAI therapy was 15.91±10.73 and 23.86±7.77 respectively, the results were not statistically significant, however, significantly decreased in VEGF expression after BAI therapy (P<0.05). The maximum enhancement value and steepest slope of TIC were negatively correlated with VEGF protein expression (P<0.05), and other parameters were not correlated with both MVD and VEGF. Conclusion The changes of some parameters of dynamic MRI may be useful in the quantitative estimation of the effects of BAI therapy on microvascular characteristics of central bronchogenic carcinoma, but they are not correlated with MVD and VEGF protein expression.