Tuncbilek Nermin, Kaplan Mustafa, Altaner Semsi, Atakan Irfan H, Süt Necdet, Inci Osman, Demir Mustafa Kemal
Radiology Department, Trakya University School of Medicine, Kocasinan mah, Dr. Sadik Ahmet caddesi, Uzunoglu 2 Apt. No:60 Daire: 4/13, 22030 Edirne, Turkey.
AJR Am J Roentgenol. 2009 Apr;192(4):949-55. doi: 10.2214/AJR.08.1332.
The aim of this study was to investigate dynamic contrast-enhanced MRI (DCE-MRI) for the noninvasive measurement of bladder cancer angiogenesis by correlation with microvessel density, histologic grade, and tumor staging, and to predict the outcome of local recurrence.
Twenty-four patients with bladder cancer were examined using DCE-MRI. Hemodynamic parameters obtained by DCE-MRI included peak time enhancement in the first minute (E(max/1)) after contrast administration, second minute (E(max/2)), third minute (E(max/3)), fourth minute (E(max/4)), and fifth minute (E(max/5)), and the steepest slope. Microvessel density was identified by immunostaining of endothelial cells using FVIII-related antigen. The Mann-Whitney U test, multivariate discriminant analysis, Spearman's correlation coefficient, and analysis of variance were used for statistical analysis.
Correlation was seen between DCE-MRI parameters (E(max/1) and steepest slope) and microvessel density (p < 0.05). E(max/1) and steepest slope were found to have a statistically significant correlation with histologic grade (p < 0.05 and p < 0.01, respectively). A significant difference was seen between groups of patients with and without local recurrence with regard to two of the DCE-MRI parameters (p < 0.05 for E(max/1) and E(max/2)).
The contrast enhancement patterns on DCE-MRI are influenced by tumor angiogenesis, as reflected by elevated microvessel density expression. Therefore, they are valuable indicators for assessing tumor angiogenic activity and tumor neovascularization in bladder cancers.
本研究旨在通过与微血管密度、组织学分级和肿瘤分期相关联，探讨动态对比增强磁共振成像（DCE-MRI）用于膀胱癌血管生成的无创测量，并预测局部复发的结果。
对24例膀胱癌患者进行DCE-MRI检查。通过DCE-MRI获得的血流动力学参数包括注射造影剂后第1分钟（E(max/1)）、第2分钟（E(max/2)）、第3分钟（E(max/3)）、第4分钟（E(max/4)）和第5分钟（E(max/5)）的峰值增强以及最陡斜率。使用FVIII相关抗原对内皮细胞进行免疫染色来确定微血管密度。采用Mann-Whitney U检验、多变量判别分析、Spearman相关系数和方差分析进行统计分析。
DCE-MRI参数（E(max/1)和最陡斜率）与微血管密度之间存在相关性（p < 0.05）。发现E(max/1)和最陡斜率与组织学分级具有统计学显著相关性（分别为p < 0.05和p < 0.01）。在有无局部复发的患者组之间，两个DCE-MRI参数存在显著差异（E(max/1)和E(max/2)的p < 0.05）。
DCE-MRI上的对比增强模式受肿瘤血管生成影响，这通过微血管密度表达升高得以体现。因此，它们是评估膀胱癌肿瘤血管生成活性和肿瘤新生血管形成的有价值指标。
