Department of Radiology, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, Shaanxi 710061, P.R. China.
Department of Geriatric cardiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China.
Acad Radiol. 2020 Mar;27(3):354-360. doi: 10.1016/j.acra.2019.04.023.
To investigate the correlation between dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) parameters and angiogenesis and to explore prospectively the feasibility of using DSC-MRI to differentiate malignant from benign soft tissue tumors (STTs) in limbs.
This prospective study included 33 patients with STTs in limbs who underwent DSC-MRI after bolus Gd-DTPA infusion. All STTs were confirmed by pathological examination after surgery and microvessel density (MVD), vascular endothelial growth factor (VEGF) expression, were evaluated by immune-histochemical analysis. Semiquantitative DSC-MRI parameters, including negative enhancement integral (NEI), maximum slopes of decrease (MSD) and increase (MSI), and mean time to enhancement were calculated by postprocessing in workstation. The correlation was analyzed between DSC-MRI parameters and angiogenesis factors. Then, the DSC-MRI parameters were compared between benign and malignant STTs and evaluated for diagnostic efficiency by receiver operating characteristic.
The 33 evaluated tumors were consisted of 13 benign and 20 malignant STTs in limbs. Significant positive correlations were observed between NEI, MSD, MSI and MVD, VEGF (p < 0.05). However, mean time to enhancement had no correlation with MVD and VEGF. The benign and malignant STTs differed significantly in terms of NEI, MSD, and MSI (p < 0.05). The areas under the curve (AUC) of NEI, MSD, and MSI were 0.915, 0.862, and 0.815 for discriminating between benign and malignant STTs, respectively.
DSC-MRI parameters are positively correlated with MVD and VEGF, which can evaluate angiogenesis indirectly. Furthermore, DSC-MRI can be considered as one of assistant noninvasive MR imaging technique in differentiation between benign and malignant STTs in limbs.
探讨动态磁敏感对比磁共振成像（DSC-MRI）参数与血管生成的相关性，并前瞻性探索 DSC-MRI 区分肢体良恶性软组织肿瘤（STT）的可行性。
本前瞻性研究纳入 33 例经静脉团注钆喷替酸葡甲胺（Gd-DTPA）后行 DSC-MRI 检查的肢体 STT 患者。所有 STT 均经术后病理检查证实，并采用免疫组织化学法分析微血管密度（MVD）和血管内皮生长因子（VEGF）的表达。工作站后处理计算半定量 DSC-MRI 参数，包括负增强积分（NEI）、下降斜率最大值（MSD）和上升斜率最大值（MSI）以及增强时间均值。分析 DSC-MRI 参数与血管生成因子的相关性，比较良恶性 STT 之间的 DSC-MRI 参数，并通过受试者工作特征曲线评价其诊断效能。
33 例可评估肿瘤中，良性 13 例，恶性 20 例。NEI、MSD、MSI 与 MVD、VEGF 呈显著正相关（p<0.05），而增强时间均值与 MVD、VEGF 无相关性。良性和恶性 STT 之间在 NEI、MSD 和 MSI 方面差异有统计学意义（p<0.05）。NEI、MSD 和 MSI 鉴别良恶性 STT 的曲线下面积（AUC）分别为 0.915、0.862 和 0.815。
DSC-MRI 参数与 MVD 和 VEGF 呈正相关，可间接评估血管生成。此外，DSC-MRI 可作为肢体良恶性 STT 鉴别诊断的一种辅助无创磁共振成像技术。
