Dip. Scienze Morfologico-Biomediche, sez. Anatomia ed Istologia, Università di Verona, Verona, Italy.
Microvasc Res. 2009 Dec;78(3):370-8. doi: 10.1016/j.mvr.2009.09.004. Epub 2009 Oct 3.
The use of contrast-enhanced magnetic resonance imaging (MRI) for the assessment of breast carcinomas reveals satisfactory sensitivity, but due to low specificity, it does not obviate the need for subsequent tissue sampling. Its capability to differentiate benign from malignant lesion is under continuous investigation. Dynamic contrast-enhanced MRI (DCE-MRI) could improve specificity of MRI through the analysis of the kinetic of contrast enhancement. In particular, the study of the washout pattern is considered a promising tool to improve in vivo diagnosis and even to evaluate the response under chemotherapy. To provide a comprehensive characterization of this parameter in malignant tumor models, in vivo mapping of the washout of small molecular contrast agent (Gd-DTPA, molecular weight 0.57 kDa) was carried out in three transplanted/spontaneous mammary tumors, which differed in their histopathological and microvascular features. It resulted that in all models around 40% of tumor volume lacks efficient washout; washout areas are frequently, but not always, restricted to the tumor periphery and that non-washout areas are not restricted to necrotic regions. Difference in the distribution of lymphatic vessels characterized spontaneous vs. transplanted tumors but did not produce a corresponding different washout pattern, confirming that Gd-DTPA drainage does not mainly depend on lymphatic architecture. Finally, the efficiency of washout is correlated with parameters obtainable during the earlier phases of the enhancement curve and in malignant tumors it could be indirectly estimated from them.
使用对比增强磁共振成像(MRI)评估乳腺癌具有令人满意的敏感性,但由于特异性低,仍需要进行后续的组织取样。其区分良恶性病变的能力仍在不断研究中。动态对比增强 MRI(DCE-MRI)可通过分析对比增强的动力学来提高 MRI 的特异性。特别是,洗脱模式的研究被认为是一种有前途的工具,可以改善体内诊断,甚至可以评估化疗中的反应。为了全面描述恶性肿瘤模型中的这个参数,对三种在组织学和微血管特征上不同的移植/自发乳腺癌模型中的小分子造影剂(Gd-DTPA,分子量 0.57 kDa)的洗脱进行了体内定量分析。结果表明,在所有模型中,大约 40%的肿瘤体积缺乏有效的洗脱;洗脱区域经常(但不总是)局限于肿瘤边缘,而非洗脱区域并不局限于坏死区域。淋巴管分布的差异可区分自发和移植肿瘤,但不会产生相应的不同洗脱模式,证实 Gd-DTPA 引流并不主要依赖于淋巴管结构。最后,洗脱效率与增强曲线早期阶段获得的参数相关,并且在恶性肿瘤中,可以从这些参数间接估计洗脱效率。