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目的探讨64层螺旋CT灌注成像在评价星形细胞肿瘤血管生成中的临床应用价值。方法对26例经手术病理证实的星形细胞肿瘤患者术前行64层螺旋CT灌注扫描,测量肿瘤的各项血流灌注指标;免疫组织化学染色SP法检测肿瘤的微血管密度(MVD)和血管内皮生长因子(VEGF)表达水平。结果①高级星形细胞肿瘤组的脑血流量(BF)、血容量(BV)、表面通透性(PS)、MVD及VEGF表达均较低级星形细胞肿瘤组明显升高,两者比较差异均有统计学意义(P<0.05或P<0.01);②星形细胞肿瘤的CT灌注参数BF、BV、PS值分别与MVD、VEGF表达呈显著正相关(P均<0.01)。结论 CT灌注成像可准确反映星形细胞肿瘤瘤体内血管生成,有助于临床制定治疗方案,判断疗效及预后。
Objective To investigate the clinical value of 64-slice spiral CT perfusion imaging in the evaluation of astrocytoma angiogenesis. Methods Twenty-six patients with astrocytic tumors confirmed by surgery and pathology were preoperatively performed 64-slice spiral CT perfusion scan to measure the various perfusion indexes of tumor. The MVD and blood vessels of tumor were detected by immunohistochemical SP method, Endothelial growth factor (VEGF) expression levels. Results ① The levels of blood flow (BF), blood volume (BV), surface permeability (PS), MVD and VEGF in advanced astrocytoma group were significantly higher than those in lower grade astrocytoma group (P <0.05 or P <0.01). ② The BF, BV and PS values of CT perfusion in astrocytic tumors were positively correlated with the expression of MVD and VEGF respectively (all P <0.01). Conclusion CT perfusion imaging can accurately reflect the astrocytoma in vivo angiogenesis, help to develop a clinical treatment plan to determine the efficacy and prognosis.