[MSCT perfusion imaging and its correlation with perfusion parameters, survivin expression, MVD, and pathologic grade in hepatocellular carcinomas].

OBJECTIVE

(1)To obtain the perfusion parameters of hepatocellular carcinomas(HCCs), peritumour livers and normal livers by multi-slice CT(MSCT)and to investigate their characteristics and clinical significances;(2)To investigate the correlation among perfusion parameters, survivin expression, microvessel density(MVD)and pathologic grade of HCCs.

METHODS

A total of 31 patients with HCC (5 well-differentiated HCCs, 17 moderately differentiated HCCs, and 9 poorly differentiated HCCs) and 10 normal liver were studied. All underwent CT plain scan, perfusion scan, and conventional enhancement scan of the whole liver using 16-slice spiral CT (Philips Brilliance 16). Perfusion parameters were obtained by time-density curves (TDC) of region of interest (ROI) through the perfusion scans. Tissue sections of HCCs and their corresponding peritumour liver tissues of the 31 patients were detected by immunohistochemistry (SABC methods) for protein expression of survivin and MVD, and 10 normal liver tissue sections were as used as negative controls. The correlation among the perfusion parameters, survivin expression, MVD and pathology grade were analysed.

RESULTS

(1)The mean values of HAP, HPP, TLP, and HAI of HCCs were 27.50 mL/(min.100 mL), 19.37 mL/(min.100 mL), 46.87 mL/(min.100 mL), and 60.38%, respectively. The mean values of those of the peritumour livers were 14.93 mL/(min.100 mL), 55.70 mL/(min.100 mL), 69.63 mL/(min.100 mL), and 21.51%, respectively. The mean value of those of the normal livers were 12.22 mL/(min.100mL), 74.56 mL/(min.100 mL), 86.78 mL/(min.100 mL), and 14.00%, respectively. The values of HAP and HAI of HCCs were significantly higher than those of the peritumor livers and the normal livers(P<0.01), and the HPP and TLP of HCCs were significant lower than those of the normal livers(P<0.01).The increase of HAP and decrease of HPP of peritumor livers were both significant compared with that of the normal livers(P<0.05). The HAP, HPP, and HAI of HCCs were significantly different from those of peritumor livers (P<0.01)except TLP. (2) Survivin expression in HCCs was detected in 23/31(74.1%), which was significantly higher than that in corresponding non-cancerous adjacent liver tissues and normal liver tissues (P<0.01). Survivin expression was positively correlated with MVD in HCCs. (3) HAP values were significantly and positively correlated with survivin expression (r=0.932,P<0.01)in HCCs.(4)The values of HAP and HAI were correlated with the pathologic grade in HCCs, and those values were increased gradually(P<0.05) among well differentiated HCCs, moderately differentiated, and poorly differentiated HCCs.

CONCLUSION

CTPI can quantitatively reflect abnormal blood supply of HCCs, which will be helpful for the detection and differentiation of lesions. CT perfusion parameters well correlate with survivin expression, MVD, and the pathologic grade in HCCs, which illustrate that CTPI could hopefully be used to evaluate the angiogenesis and biological behaviors of HCCs prospectively, noninvasively, and dynamically.