Andersen C, Jensen F T
Department of Neurosurgery, Aarhus University Hospital, Denmark.
Acta Neurochir (Wien). 1998;140(9):919-24. doi: 10.1007/s007010050194.
To study differences in tumour capillary permeability as expressed by the unidirectional transport rate constant Ki, extracellular distribution volume Vd and relaxation time T1 in human intracranial tumours using a recently described MRI method, and apply the model to study differences in these parameters after glucocorticoid (GC) treatment.
Seventeen brain tumour patients were studied. There were seven glioblastoma (GLI), four metastasis (MET), and six meningioma (MM) patients. Nine patients were studied before and after an average of 6 days of GC treatment. A 1.5 Tesla MR imaging scanner was used, and a two compartment diffusion model for Gd-DTPA was applied.
There was a significant difference between pre-treatment Ki in GLI's and MM's, MM's having the highest permeability. There were no significant differences between pre-treatment Vd or T1 among the different tumour types. After GC treatment Ki decreased 15% on average (52% in GLI's and MET's, but only 4% in MM's). Vd decreased 14% on average in all tumours, but 47% in GLI's and MET's (p < 0.04), but increased 2% during treatment of MM's. T1 decreased 9% in all tumours (p < 0.04), but 11% in GLI's and MET's (p < 0.003), and only 6% in MM's.
It is possible to estimate Ki, Vd and T1 simultaneously in brain tumour patients in a clinical MRI system. Ki was significantly higher in MM's compared to GLI's and MET's suggesting that MM's differ in some physiological parameter at the blood-tumour interface. MM's did not respond to GC treatment, neither in Ki, Vd nor in T1, whereas GLI's and MET's primarily decreased their extracellular distribution volume, suggesting that this may be an important effect in GC's mode of action in these tumour types.
使用一种最近描述的磁共振成像（MRI）方法，研究人类颅内肿瘤中肿瘤毛细血管通透性的差异，该差异通过单向转运速率常数Ki、细胞外分布容积Vd和弛豫时间T1来表示，并应用该模型研究糖皮质激素（GC）治疗后这些参数的差异。
对17例脑肿瘤患者进行了研究。其中有7例胶质母细胞瘤（GLI）患者、4例转移瘤（MET）患者和6例脑膜瘤（MM）患者。9例患者在平均6天的GC治疗前后接受了研究。使用1.5特斯拉的MR成像扫描仪，并应用了针对钆喷酸葡胺（Gd-DTPA）的双室扩散模型。
GLI患者和MM患者治疗前的Ki存在显著差异，MM患者的通透性最高。不同肿瘤类型治疗前的Vd或T1之间无显著差异。GC治疗后，Ki平均下降15%（GLI患者和MET患者下降52%，但MM患者仅下降4%）。所有肿瘤的Vd平均下降14%，但GLI患者和MET患者下降47%（p<0.04），而MM患者在治疗期间增加2%。所有肿瘤的T1下降9%（p<0.04），但GLI患者和MET患者下降11%（p<0.003），MM患者仅下降6%。
在临床MRI系统中，可以同时估计脑肿瘤患者的Ki、Vd和T1。与GLI患者和MET患者相比，MM患者的Ki显著更高，这表明MM患者在血肿瘤界面的某些生理参数上存在差异。MM患者对GC治疗在Ki、Vd或T1方面均无反应，而GLI患者和MET患者主要是细胞外分布容积减少，这表明这可能是GC对这些肿瘤类型作用方式中的一个重要效应。
