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目的探讨周围型肺腺癌MRI动态增强参数与血管生成之间的相关性。资料与方法37例周围型肺腺癌患者行MRI动态增强扫描,用免疫组织化学测定微血管密度(MVD)并标定血管内皮生长因子(VEGF),评价MRI动态增强参数强化峰值(PH)、最大线性强化斜率(SS)、最大强化率(Emax)、增强后1～6min时的信号强化率(E1～6)与肺腺癌MVD的相关性,并比较VEGF表达阳性组与阴性组病例其MRI动态增强参数的差异。结果37例肺腺癌的MVD为68.31±19.84。MRI动态增强参数PH、SS、Emax、E1～6与肺腺癌的MVD呈正相关(P<0.001),其中以SS与MVD相关性最强(r=0.827,P<0.001)。26例VEGF表达阳性的肺腺癌MVD为79.47±21.35,11例VEGF表达阴性的肺腺癌其MVD为43.16±17.85,二者之间差异显著(P<0.001)。VEGF表达阳性的肺腺癌其MRI动态增强所有参数均明显高于VEGF表达阴性的肺腺癌(P<0.001)。结论肺腺癌MR动态增强参数与MVD呈正相关,VEGF表达阳性的肺腺癌其MR动态增强参数明显高于VEGF表达阴性的肺腺癌。
Objective To investigate the correlation between dynamic MRI parameters and angiogenesis in peripheral lung adenocarcinoma. Materials and Methods 37 cases of peripheral pulmonary adenocarcinoma underwent MRI dynamic contrast-enhanced scanning. Immunohistochemistry was used to measure the microvessel density (MVD) and to determine the vascular endothelial growth factor (VEGF). The dynamic enhancement parameters of enhanced MRI peak value (PH), maximum linear (SS), maximum enhancement rate (Emax), enhanced signal intensity (E1 ~ 6) at 1 ~ 6min after the enhancement and lung adenocarcinoma MVD, and compared the MRI dynamic expression of VEGF expression positive group and negative group Enhance the difference of parameters. Results The MVD of 37 cases of lung adenocarcinoma was 68.31 ± 19.84. The dynamic enhancement parameters of MRI, PH, SS, Emax and E1 ~ 6 were positively correlated with the MVD of lung adenocarcinoma (P <0.001). The correlation between SS and MVD was the strongest (r = 0.827, P <0.001). The MVD of lung adenocarcinoma of 26 cases with positive expression of VEGF was 79.47 ± 21.35 and that of 11 cases of negative expression of VEGF was 43.16 ± 17.85 (P <0.001). All the parameters of dynamic MRI enhancement of VEGF positive lung adenocarcinoma were significantly higher than those of negative lung adenocarcinoma of VEGF expression (P <0.001). Conclusions MR dynamic enhancement parameters of lung adenocarcinoma are positively correlated with MVD. The dynamic enhancement parameters of MR in lung adenocarcinoma with VEGF expression are obviously higher than those with negative VEGF expression.