乳腺良恶性病变动态增强MRI与血管内皮生长因子及微血管密度相关性的研究

目的:分析乳腺良、恶性病变核磁共振成像(MRI)动态增强模式与其组织学特点、血管生成间的关系,探讨 动态增强MRI在评价乳腺病变血管生成及相关病理学变化的应用价值。　方法:对40例经手术后病理证实乳腺 良、恶性病变患者的动态增强MRI资料及病理资料进行对照研究。MRI动态增强扫描采用脂肪抑制3D FSPGR序 列,运用Functool2功能软件在伪彩图上选择感兴趣区,绘制时间 信号强度曲线,并计算早期强化率、信号强度峰 值(Emax)、最大信号到达峰值时间(Tmax)。所有患者均行免疫组化微血管密度(MVD)和血管内皮生长因子 (VEGF)表达检测,并在苏木精 伊红(H E)染色切片观察炎性反应程度。　结果:40例VEGF低度表达者与高度 表达者间MVD差异有统计学意义(P<0.05),乳腺良、恶性病变的MVD和VEGF表达水平及炎性反应程度差异均 有显著性意义(P<0.01);良、恶性病变动态增强参数指标中早期强化率和Tmax差异有显著性意义(P<0.05),恶性 病变组Emax高于良性组,但两者差异无统计学意义(P>0.05),良、恶性病变的时间 信号曲线类型差异有显著性意 义(P<0.01);相关分析显示,Emax与MVD及VEGF分级,早期强化率与VEGF分级无相关性(P>0.05),其余指标 均显示有相关性(P<0.05),其中Tmax与MVD、VEGF分级、炎性反应程度

Dynamic contrast-enhanced MRI of breast disease: correlation of MR findings with vascular endothelial growth factor and microvessel density

Objective: To determine the relation dynamic contrast-enhanced magnetic resonance imaging (MRI) and histologic features and angiogenesis of breast disease. Methods: Forty patients with breast disease, diagnosed by histopathology were reviewed, including imaging and pathological data. Dynamic MRI was performed by a fat-suppressed 3D-FSPGR sequence ,Time-Signal curve was acquired by Functool 2 software, then early-phase enhancement rate and E max , T max were acquired. The mean MVD and VEGF expression of the lesions were measured with immunohistology. Evaluation of inflammatory changes was assessed by histology. Results: The MVD , VEGF expression and inflammatory scores of malignant tumor were significantly higher than that of benign tumor(P<0.01); The early-phase enhancement rate and T max were significantly higher in malignant tumor and benign tumor (P<0.05). There was no different between malignant tumor and benign tumor (P>0.05), The Time-SI curve between malignant and benign was significant different(P<0.01). All the correlation mentioned above showed statistical significance except that the correlation between E max and MVD or VEGF expression, Conclusion: Dynamic contrast-enhanced MRI of breast neoplasms are closely related to angiogenesis and inflammatory changes.