乳腺肿瘤磁共振动态增强模式及与肿瘤微血管密度的相关性研究

目的:研究乳腺肿瘤动态增强MRI的强化模式及与肿瘤微血管密度的相关性.材料和方法:58例乳腺肿瘤患者,共66个病灶(恶性49个、良性17个).行动态增强MRI扫描,评价最大强化斜率(Slopemax)、峰值强化率(Emax)、峰值时间(Tmax)、增强后1～5min的强化率等指标及时间-信号强度曲线类型在良、恶性肿瘤间的差别.除2例皮纤维肉瘤,病理标本均行CD34免疫组化染色,微血管计数,采用相关分析评价其与上述强化指标及强化曲线类型的相关性.结果:乳腺良、恶性肿瘤组间的Slopemax、Emax、Tmax、E(1-3),时间-信号强度曲线类型差别有统计学意义(P＜0.05).两组间肿瘤微血管密度的差别也有明显的统计学意义(P＜0.0001),Slopemax、Emax、Tmax、E(1-4)及时间-信号强度类型与肿瘤微血管密度密切相关(P＜0.05).结论:乳腺良、恶性肿瘤的强化模式的差别与肿瘤微血管密度密切相关,可以根据不同的强化模式进行乳腺良、恶性肿瘤的鉴别.

Study of Enhancing Pattern and Correlationship with Tumor Microvessel Density in Breast Tumors with Dynamic MRI

Purpose: To study the different enhancing pattern of benign and malignant breast tumors with dynamic contrasted MRI, and to assess the correlation between TMD and the enhancing pattern. Materials and Methods: 58 patients who were confirmed as breast tumors were examined with dynamic contrasted MRI (2D - FSPGR) . A total of 66 lesions(6 patient with multiple lesions), including 49 malignant and 17 benign tumors, were estimated. The difference of the values of Slopemax,Emax,Tmax E(1-5) and type of time -signal intensity curve between benign and malignant breast tumors were evaluated. 64 pathologic specimens were immunohistochemically stained with CD34 antibody except 2 dermatofibrosarcomas. And the counting of TMD was according to Weidner' s method. The correlation between TMD and enhancement parameters mentioned above and type of enhancement curve was analyzed. Results: There was significant difference between benign and malignant breast tumors with the values of Slopemax, Emax, Tmax, E(1 -3) and the type of signal intensty curve (P < 0.05) . There was significant difference between benign and malignant breast tumors on TMD(P < 0.0001) . The correlation between Slopemax, Emax, Tmax, E(1-4), type of enhancement curve and TMD had statistical significant (P < 0.05) .Conclusion: There was correlation between TMD and the enhancing pattern of breast tumors in dynamic contrasted MRI. The enhancement parameter and the type of enhancement curve were useful to differentiate benign and malignant breast tumors.