Roberts H C, Roberts T P, Bollen A W, Ley S, Brasch R C, Dillon W P
Department of Radiology, University of California, San Francisco 94143, USA.
Acad Radiol. 2001 May;8(5):384-91. doi: 10.1016/S1076-6332(03)80545-7.
Dynamic contrast material-enhanced magnetic resonance (MR) imaging may be used to quantify fractional blood volume (fBV) and microvascular permeability in human brain tumors. Hypothesis is that these measurements correlate with tumor histologic grade and immunohistologically assessed mitotic activity.
Thirty-eight patients with newly diagnosed gliomas underwent MR imaging consisting of dynamic three-dimensional spoiled gradient-recalled acquisition in the steady state image sets following bolus injections of a single dose of gadodiamide. Signal intensity changes in blood and tissue were kinetically analyzed, yielding estimates of fBV and microvascular permeability (k). Tumor specimens were graded with the World Health Organization-II four-point grading score. MIB-1 immunohistochemical labeling (anti-Ki-67 monoclonal antibody) was performed in 22 patients to evaluate mitotic activity.
Histologic study revealed nine grade 2, 14 grade 3, and 15 grade 4 tumors. fBV ranged from 0.4% to 24%, k from -0.4 to 31.4 mL/100 cm3 x min, and MIB-1 labeling indexes from 1.7% to 42.8%. Correlation to the tumor grade was highest for permeability (r = 0.73), followed by the MIB-1 index (r = 0.63), and fBV (r = 0.48). Correlation between k and MIB-1 index was strong (r = 0.84). There was no statistically significant difference between the fBV of any of the groups. Despite some overlap between the permeability values of specific tumors from different grades, differences were statistically significant. The MIB-1 index was significantly different between grades 3 and 4 but not between grades 2 and 3.
Dynamic contrast-enhanced MR imaging allows noninvasive determination of tumor fBV and microvascular permeability k. k is more reliable than the MIB-1 labeling index for differentiating grade 2 from grade 3 tumors.
动态对比剂增强磁共振（MR）成像可用于量化人脑肿瘤中的血容量分数（fBV）和微血管通透性。假设是这些测量值与肿瘤组织学分级和免疫组织化学评估的有丝分裂活性相关。
38例新诊断的胶质瘤患者接受了MR成像，包括在单次注射钆双胺后的稳态图像集中进行动态三维扰相梯度回波采集。对血液和组织中的信号强度变化进行动力学分析，得出fBV和微血管通透性（k）的估计值。肿瘤标本采用世界卫生组织-II级四点分级评分法进行分级。对22例患者进行MIB-1免疫组织化学标记（抗Ki-67单克隆抗体）以评估有丝分裂活性。
组织学研究显示9例2级、14例3级和15例4级肿瘤。fBV范围为0.4%至24%，k范围为-0.4至31.4 mL/100 cm3×min，MIB-1标记指数范围为1.7%至42.8%。与肿瘤分级的相关性以通透性最高（r = 0.73），其次是MIB-1指数（r = 0.63）和fBV（r = 0.48）。k与MIB-1指数之间的相关性很强（r = 0.84）。任何组之间的fBV均无统计学显著差异。尽管不同分级的特定肿瘤的通透性值存在一些重叠，但差异具有统计学显著性。MIB-1指数在3级和4级之间有显著差异，但在2级和3级之间没有显著差异。
动态对比增强MR成像可无创测定肿瘤fBV和微血管通透性k。在区分2级和3级肿瘤方面，k比MIB-1标记指数更可靠。
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