【摘要】 目的 探究动态对比增强磁共振成像（dynamic contrast-enhanced magnetic resonance imaging, DCE-MRI）定量灌注参数与肝外胆管癌（extrahepatic cholangiocarcinoma, ECCA）病理分化程度和血管生成的相关性。材料与方法 对50例ECCA患者术前行常规MRI、DCE-MRI扫描；使用免疫组织化学法检测术后标本组织的微血管密度（micro vascular density, MVD）及血管内皮生长因子（vascular endothelial growth factor, VEGF）表达情况，通过Spearman检验分析容积转移常数(volume transport constant, K^trans)、血管外细胞外间隙容积比（extravascular extracellular volume fraction, V_e）、速率常数(rate constant, K_ep)与病理分化程度、MVD、VEGF表达量的关系。结果 50例ECCA患者高分化、中分化和低分化分别15例、23例、12例。ECCA患者的K^trans、V_e、K_ep与病理分化程度、VEGF表达量无相关性（P>0.05）;K^trans与MVD呈正相关（r=0.524,P<0.05）,K_ep值、V_e值与MVD无相关性（P>0.05）。结论 DCE-MRI参数K^trans与MVD呈正相关，证实了其在一定程度上无创反映ECCA肿瘤血管生成的可行性；然而，鉴于K_ep及V_e值未显示类似关联，其对侵袭性及预后的评估效能仍需更大样本的前瞻性研究进一步验证。更多还原

【Abstract】 Objective: To explore the correlation between quantitative perfusion parameters of dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） and the pathological grade and angiogenesis of extrahepatic cholangiocarcinoma（ECCA）. Materials and Methods: Fifty patients with ECCA underwent conventional MRI and DCE-MRI scans before surgery. The microvessel density（MVD） and vascular endothelial growth factor（VEGF） expression in postoperative specimens were detected by immunohistochemistry. The relationships between DCE-MRI quantitative parameters and pathological grade, MVD, and VEGF expression were analyzed. Results: Among the 50 patients with ECCA, 15 cases were well differentiated, 23 cases were moderately differentiated, and 12 cases were poorly differentiated. The volume transfer constant(K^trans) and extracellular extravascular volume fraction（V_e） of ECCA patients were not correlated with pathological grade or VEGF expression（P > 0.05）. K^trans was positively correlated with MVD（r = 0.524, P < 0.001）, while the rate constant(K_ep) and V_e were not related to MVD（P > 0.05）. Conclusions: The DCE-MRI parameter K^trans is positively correlated with MVD, confirming its feasibility in non-invasively reflecting the angiogenesis of ECCA to a certain extent; however, since K_ep and V_e values do not show a similar correlation, their efficacy in evaluating invasiveness and prognosis still needs to be further verified by prospective studies with larger samples.更多还原