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目的:利用多MSCT灌注成像探讨脑胶质瘤表面通透性(PS)值在其术前分级中的价值及与血管内皮生长因子(VEGF)表达程度的相关性。方法:对37例CT平扫疑为脑胶质瘤患者行MSCT灌注成像扫描,观察肿瘤灌注PS图的特点,分析不同病理分级脑胶质瘤实质区的PS值的差异,术后对肿瘤组织行免疫组化检查,观察VEGF表达程度,并与肿瘤的分级及PS值进行对照分析。结果:37例中胶质瘤Ⅰ~Ⅱ级11例,Ⅲ级19例,Ⅳ级7例。不同级别组胶质瘤实质的PS均值分别为(3.38±1.62)(、14.83±3.10)及(38.03±9.02)ml/(min.100mg),相应VEGF表达的平均光密度(ALD)值分别为0.108±0.038、0.197±0.042及0.256±0.050。胶质瘤的PS值及VEGF表达的ALD值均随脑胶质瘤病理级别的升高而升高,组间差异有极显著性意义(F=28.44,P<0.01)。胶质瘤实质区最大PS值与VEGF的ALD值呈正相关(r=0.79,P<0.05)。结论:CT灌注成像PS值可间接反映胶质瘤的血管生成情况,为脑胶质瘤术前分级提供重要的功能信息。
OBJECTIVE: To investigate the value of the surface permeability (PS) value of gliomas in preoperative classification and the correlation with the expression of vascular endothelial growth factor (VEGF) using multi-MSCT perfusion imaging. Methods: Thirty-seven patients with suspected brain gliomas underwent MSCT perfusion imaging. The characteristics of PS perfusion were observed, and the difference of PS values between different gliomas in different pathological grades was analyzed. Immunohistochemistry was performed to observe the expression of VEGF, and with the tumor grade and PS value of controlled analysis. Results: Among the 37 gliomas, 11 were grade Ⅰ ~ Ⅱ, 19 were grade Ⅲ and 7 were grade Ⅳ. The average PS values of glioma in different groups were (3.38 ± 1.62) (14.83 ± 3.10) and (38.03 ± 9.02) ml / (100.0 mg), respectively. The mean optical density (ALD) 0.108 ± 0.038, 0.097 ± 0.042 and 0.256 ± 0.050. The gliomas PS value and VEGF expression of ALD value with the glioma pathological grade increased, the difference between the groups was extremely significant (F = 28.44, P <0.01). The maximum PS value in the parenchyma of glioma was positively correlated with the ALD of VEGF (r = 0.79, P <0.05). Conclusion: CT perfusion imaging PS value can indirectly reflect glioma angiogenesis, provide important functional information for glioma preoperative grading.