人类腹主动脉瘤管腔内血栓中铁吞噬作用的磁共振成像。

MR imaging of iron phagocytosis in intraluminal thrombi of abdominal aortic aneurysms in humans.

机构信息

Departments of Medical Imaging and Pathology, Centre Hospitalier Chrétien, Rue de Hesbaye, 75, B-4000 Liège, Belgium.

出版信息

Radiology. 2010 Mar;254(3):973-81. doi: 10.1148/radiol.09090657.

DOI:10.1148/radiol.09090657

PMID:20177108

Abstract

PURPOSE

To prospectively determine if superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging could help visualize leukocyte phagocytic activities in human abdominal aortic aneurysms (AAAs).

MATERIALS AND METHODS

This study was approved by the institutional ethics committee; all patients gave informed consent. Preoperative MR imaging data, including unenhanced and SPIO-enhanced T1-, T2*-, and T2-weighted transverse images of the entire AAA, obtained 1 hour after contrast enhancement from 15 patients (mean age, 72.7 years +/- 8.2; range, 60-83 years), 10 men (mean age, 73.5 years +/- 7.9; range, 60-83 years) and five women (mean age, 71.2 years +/- 9.4; range 60-82), were retrospectively evaluated. Morphologic appearance and semiquantitative and contrast-to-noise ratio (CNR) analyses of the thrombi were performed. Thrombi were analyzed semiquantitatively at microscopy after staining with hematoxylin-eosin, CD68, and CD66b. Levels of promatrix metalloproteinase (pro-MMP)-2 and pro-MMP-9, MMP-2 and MMP-9, and their mRNA located in the thrombus were assessed by using zymography and quantitative reverse transcriptase polymerase chain reaction analysis. Nonparametric statistics of the Spearman rank correlation were calculated to evaluate correlations between the aneurysm thrombus signal level decrease after SPIO and the levels of CD68(+), CD66b(+) cells, pro-MMP-2 and pro-MMP-9, MMP-2 and MMP-9, and MMP-9 mRNA.

RESULTS

The pre-SPIO CNRs in the luminal sublayer of the thrombus and the deeper thrombus were -10.20 +/- 12.69 and -5.68 +/-10.38, respectively. After SPIO, the CNRs decreased to -21.34 +/-13.07 (P < .001) and -12.44 +/- 14.56, respectively (P < .012). There was a significant linear correlation between the thrombus signal level decrease and the levels of CD68(+) and CD66b(+) cells, pro-MMP-9, and MMP-9 mRNA (P < .05).

CONCLUSION

MR imaging allows in vivo demonstration of SPIO uptake at the luminal interface of the thrombus. This uptake is correlated to the abundance of leukocytes.

SUPPLEMENTAL MATERIAL

http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.09090657/-/DC1.

摘要

目的

前瞻性地确定超顺磁氧化铁（SPIO）增强磁共振成像是否有助于可视化人类腹主动脉瘤（AAA）中的白细胞吞噬活性。

材料与方法

本研究得到机构伦理委员会的批准；所有患者均签署了知情同意书。术前磁共振成像数据，包括增强前和增强后 1 小时获得的整个 AAA 的 T1、T2*和 T2 加权横断位图像，来自 15 例患者（平均年龄 72.7 岁 +/- 8.2；范围，60-83 岁），10 例男性（平均年龄 73.5 岁 +/- 7.9；范围 60-83 岁）和 5 例女性（平均年龄 71.2 岁 +/- 9.4；范围 60-82）。对血栓的形态外观和半定量及对比噪声比（CNR）分析进行了回顾性评估。血栓通过苏木精-伊红、CD68 和 CD66b 染色后在显微镜下进行半定量分析。使用明胶酶谱和定量逆转录聚合酶链反应分析评估基质金属蛋白酶（MMP）-2 和 MMP-9、其前体（pro-MMP）-2 和 pro-MMP-9 及其位于血栓中的 mRNA 的水平。采用 Spearman 秩相关的非参数统计学方法评估 SPIO 后动脉瘤血栓信号强度降低与 CD68（+）、CD66b（+）细胞、pro-MMP-2 和 pro-MMP-9、MMP-2 和 MMP-9 以及 MMP-9 mRNA 水平之间的相关性。

结果

血栓的管腔亚层和深层的预 SPIO CNR 分别为 -10.20 +/- 12.69 和 -5.68 +/-10.38。SPIO 后，CNR 分别降低至 -21.34 +/- 13.07（P <.001）和 -12.44 +/- 14.56（P <.012）。血栓信号强度降低与 CD68（+）和 CD66b（+）细胞、pro-MMP-9 和 MMP-9 mRNA 水平之间存在显著的线性相关性（P <.05）。