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.

The correlation between intraoperative contrast-enhanced ultrasound quantitative parameters and microvessel density of cerebral gliomas

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.