磁共振体素内不相干运动和动态对比增强成像可鉴别非典型软骨肿瘤和高级别软骨肉瘤：与组织学血管特征的相关性。
Intravoxel Incoherent Motion and Dynamic Contrast-Enhanced Magnetic Resonance Imaging Can Differentiate Between Atypical Cartilaginous Tumors and High-Grade Chondrosarcoma: Correlation With Histological Vessel Characteristics.
机构信息
From the Department of Radiology, Children's Hospital of Shanxi.
Department of Radiology, Shanxi Traditional Chinese Medical Hospital.
出版信息
J Comput Assist Tomogr. 2024;48(1):123-128. doi: 10.1097/RCT.0000000000001515. Epub 2023 Aug 8.
OBJECTIVE
To differentiate between atypical cartilaginous tumors and high-grade chondrosarcoma of the major long bones using intravoxel incoherent motion (IVIM) and Dynamic Contrast-Enhanced magnetic resonance imaging (DCE-MRI), and explore the correlation of quantitative parameters with hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) and microvessel density (MVD).
METHOD
Between September 2016 and March 2022, 35 patients (17 atypical cartilaginous tumors, 18 high-grade chondrosarcoma) underwent MRI examination and pathological confirmation at our hospital. First, IVIM-derived parameters ( D , D* , and f ), and DCE-MRI parameters ( Ktrans , Kep , and V e ) were measured, and intraclass correlation efficient (ICC) and Mann-Whitney U test were performed. Second, receiver-operating characteristic curve analysis was performed to evaluate the diagnostic performance. Finally, Spearman's correlation analysis was performed between the quantitative parameters of IVIM-DWI and DCE-MRI and the immunohistochemical factors HIF-1α, VEGF, and MVD in chondrosarcoma tissue.
RESULTS
D in atypical cartilaginous tumors was significantly higher than that in high-grade chondrosarcoma ( P = 0.003), whereas D* , Ktrans , and K ep in atypical cartilaginous tumors were significantly lower than those in high-grade chondrosarcoma (all P < 0.001). Ktrans demonstrated the highest area under the curve (AUC) of 0.979. The D* , Ktrans , and K ep were positively correlated with HIF-1α, VEGF, and MVD (all P < 0.001), whereas D had no correlation with HIF-1α, VEGF, and MVD ( P = 0.113, 0.077, 0.058, respectively).
CONCLUSION
The IVIM-DWI quantitative parameters ( D , D* ) and DCE-MRI quantitative parameters ( Ktrans , Kep ) are helpful to differentiate between atypical cartilaginous tumors and high-grade chondrosarcoma and could be imaging biomarkers to reflect the expressions of HIF-1α, VEGF, and angiogenesis of chondrosarcoma.
目的
利用体素内不相干运动（IVIM）和动态对比增强磁共振成像（DCE-MRI）对主要长骨的非典型软骨性肿瘤和高级别软骨肉瘤进行鉴别，并探讨定量参数与缺氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）和微血管密度（MVD）的相关性。
方法
2016 年 9 月至 2022 年 3 月，我院对 35 例患者（17 例非典型软骨性肿瘤，18 例高级别软骨肉瘤）进行 MRI 检查和病理证实。首先，测量 IVIM 衍生参数（D、D*和 f）和 DCE-MRI 参数（Ktrans、Kep和 V e），并进行组内相关系数（ICC）和 Mann-Whitney U 检验。其次，采用受试者工作特征曲线分析评估诊断效能。最后，采用 Spearman 相关分析对软骨肉瘤组织中 IVIM-DWI 定量参数与免疫组化因子 HIF-1α、VEGF 和 MVD 之间的相关性进行分析。
结果
非典型软骨性肿瘤的 D 值明显高于高级别软骨肉瘤（P = 0.003），而非典型软骨性肿瘤的 D*、Ktrans 和 Kep 值明显低于高级别软骨肉瘤（均 P < 0.001）。Ktrans 具有最高的曲线下面积（AUC）0.979。D*、Ktrans 和 Kep 与 HIF-1α、VEGF 和 MVD 呈正相关（均 P < 0.001），而 D 与 HIF-1α、VEGF 和 MVD 均无相关性（P = 0.113、0.077、0.058）。
结论
IVIM-DWI 定量参数（D、D*）和 DCE-MRI 定量参数（Ktrans、Kep）有助于鉴别非典型软骨性肿瘤和高级别软骨肉瘤，可作为反映软骨肉瘤 HIF-1α、VEGF 和血管生成表达的影像学标志物。
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