Correlation of Immunohistologic and Perfusion Vascular Parameters with MR Contrast Enhancement Using Image-guided Biopsy Specimens in Gliomas
Correlation of Immunohistologic and Perfusion Vascular Parameters with MR Contrast Enhancement Using Image-guided Biopsy Specimens in Gliomas
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DOI：
10.1016/j.acra.2011.04.003
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发表时间：
2011-08-01
影响因子：
4.8
通讯作者：
Rock, Jack P.
中科院分区：
文献类型：
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作者：
Jain, Rajan;Narang, Jayant;Rock, Jack P.
基本原理和目标：本研究的目的是将磁共振对比增强状态与免疫组织学血管参数（如微血管细胞增殖（MVCP）、微血管密度（MVD）、血管内皮生长因子受体-2（VEGFR-2）表达和从图像引导活检标本中获得的世界卫生组织（WHO）分级）相关联。我们还比较了灌注计算机断层扫描（PCT）的参数，如脑血容量（CBV），脑血流量（CBF），和渗透性表面积积（PS）的存在或不存在的contrast enhancement.Materials和方法：共26例图像引导下活检标本16例治疗幼稚胶质瘤从对比增强（CE）和nonenhancing（NE）地区的胶质瘤。对比增强状态与MVD，MVCP，VEGFR-2的表达，并从活检标本以及PCT parameters.Results获得WHO分级：对比增强显示统计学显着相关性MVCP（P = 0.003）和PS（P = 0.007）相比，各种免疫组织学和灌注血管参数。活检标本的WHO分级与对比增强有显著相关性（P = .002），MVCP（P < .001），PS值（P = .028）.结论：胶质瘤的对比增强主要来自血脑屏障的破坏，这一点可以通过其与PS和MVCP的相关性来证明，而与CBV、MVD无明显相关性，但呈正相关。对比增强也显示出与WHO分级的显著相关性，表明在异质性胶质瘤中从CE区域进行活检可能仍然会产生胶质瘤的最具侵袭性的部分，其与MVCP和PS估计值的相关性也显示了这一点。
Rationale and Objectives: The purpose of this study was to correlate the status of magnetic resonance contrast enhancement with immunohistologic vascular parameters such as microvascular cellular proliferation (MVCP), microvascular density (MVD), vascular endothelial growth factor receptor-2 (VEGFR-2) expression, and World Health Organization (WHO) grade obtained from image-guided biopsy specimens. We also compared perfusion computed tomography (PCT) parameters such as cerebral blood volume (CBV), cerebral blood flow (CBF), and permeability surface area-product (PS) with the presence or absence of contrast enhancement.Materials and Methods: A total of 26 image-guided biopsy specimens in 16 patients with treatment naive gliomas were obtained from contrast-enhancing (CE) and nonenhancing (NE) regions of the glioma. Contrast enhancement status was correlated with MVD, MVCP, VEGFR-2 expression, and WHO grade obtained from the biopsy specimen as well as with the PCT parameters.Results: Contrast enhancement showed statistically significant correlation with MVCP (P = .003) and PS (P = .007) when compared with various immunohistologic and perfusion vascular parameters. WHO grade of the biopsy specimen showed statistically significant correlation with contrast enhancement (P = .002), MVCP (P < .001), and PS values (P = .028).Conclusion: Contrast enhancement in gliomas is primarily from a break in blood-brain barrier as evidenced by its correlation with PS and MVCP, whereas it was not statistically correlated with CBV and MVD even though it showed a positive trend. Contrast enhancement also showed significant correlation with WHO grade suggesting a biopsy from CE region in a heterogeneous glioma probably will still yield the most aggressive part of the glioma is also shown by its association with MVCP and PS estimates.