【作者】 杨飞；

【导师】 刘斌；

【作者基本信息】 安徽医科大学 ， 影像医学与核医学， 2007， 硕士

【摘要】 目的研究肾癌CT灌注成像参数与组织学肿瘤微血管密度(MVD)和肿瘤血管成熟指数(VMI)之间的关系。以探讨CT灌注成像无创的评价肿瘤血管生成的价值及可行性。方法:对病理证实的22例肾癌患者进行CT灌注检查,计算血流量(BF)、血容量(BV)、平均通过时间(MTT)、毛细血管通透性(PS)的定量值,并得到各参数的灌注伪彩图。利用双标记免疫组织化学方法对肾癌标本进行CD34,α-SMA染色,以计算肿瘤微血管密度(MVD)和肿瘤血管成熟指数(VMI)。结果:1,共计22例肾癌中,透明细胞癌16例,颗粒细胞癌1例,透明细胞、颗粒细胞混合型肾癌2例,乳头状肾癌1例,鳞状细胞癌1例,弥漫性大B细胞淋巴瘤1例;2,CT灌注参数,微血管密度(MVD)和肿瘤血管成熟指数(VMI)均有较大范围的变化,灌注伪彩图反映了肿瘤的异质性;3,血流量(BF)与血容量(BV)有明显的正相关(r=0.673),血流量(BF)与平均通过时间(MTT)有明显负相关(r=-0.716);血流量(BF)和血容量(BV)与MVD之间均存在明显的相关性。相关系数分别为BF: r=0.643,p=0.001; BV: r=0.542,p=0.012;各灌注参数与肿瘤血管成熟指数(VMI)均未见明显的相关性。结论:1.CT灌注成像参数与肿瘤微血管密度有明显相关性,说明CT灌注成像可无创的评价肾癌的肿瘤血管生成。CT灌注参数伪彩图反映了肿瘤的异质性。2.CT灌注参数尚不能反映肾癌肿瘤血管的成熟程度,关于CT灌注参数与肾癌肿瘤血管成熟指数之间的关系仍需进一步研究。更多还原

【Abstract】 Objective: the purpose of our study was to evaluate the correlation between the CT perfusion parameter,the renal carcinoma microvessel density(MVD) and tumor vessel maturation indices(VMI); To determine the feability and value of CT perfusion in assessing tumor neovascularity in renal cell carcinoma.Methods: Twenty-two patients with histologically diagnosed renal cell carcinoma underwent CT perfusion. Blood flow, blood volume, mean transport time and permeability-surface area product was quantitatively calculated for all the lesion, the transverse functional CT map imagine was obtioned. A double-labeling immunohistochemical technique was used to stain CD34 and a-SMA , microvessel density(MVD) and tumor vessel maturation indices(VMI) was calculated.Results:①22 patients were involved in this study include clear cell carcinoma(n=16),granular cell carcinoma(n=1), chromophobe carcinoma(n=2), papillary carcinoma(n=1), squamous cell carcinoma(n=1),diffusion lymphoma(n=1) ; ②CT perfusion parameter,MVD,VMI varied greadly,heterogeneity was seen in functional map;③Positively correlation was seen between BF and BV(r=0.673),BF and MTT(r=-0.716);also between BF and MVD(r=0.643) ,BV and MVD(r=0.542);All CT perfusion parameter did not significantly correlate with VMIConcluions:①CT perfusion may be suited to evaluate tumor vascularity in vivo on the basis of the correlation between perfusion parameters and MVD of renal cell carcinoma. Functional CT images may reflect the heterogeneity of tumor angiogenesis.②CT perfusion can not used to access tumor vessel maturation level, the relationship betweed CT perfusion and VMI needs advanced research.更多还原