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目的探讨肾上腺腺瘤和非腺瘤血管生成[微血管密度(MVD),血管内皮生长因子(VEGF)]特点与动态增强CT表现的相关性,以阐述其动态增强机制。方法经手术病理证实的42例46个肾上腺肿块(腺瘤23个、非腺瘤18个、增生结节5个)均行动态增强CT检查和病理学检查。首先评价肾上腺腺瘤和非腺瘤动态增强CT表现,而后分析肾上腺肿块动态增强CT表现特征[时间密度(TD)曲线、廓清率(Wash)]与血管生成之间的相关关系。结果腺瘤与非腺瘤间TD曲线类型和7min延时点相对廓清率(Washr)和绝对廓清率(Washa)差异均存在统计学意义(P=0.000)。肾上腺肿块TD曲线廓清迅速组(A、C型)与廓清缓慢组(B、D、E型)间、7min延时点Washr≥34%组与<34%组间、Washa≥43%组与<43%组间MVD、VEGF表达水平差异均有统计学意义(P<0.05)。肿块廓清曲线为A、C型,和(或)Washr≥34HU,和(或)Washa≥43%组均提示为腺瘤,反之提示为非腺瘤。TD曲线廓清迅速组、7min延时点Washr≥34%组和Washa≥43%组MVD、VEGF表达水平分别高于廓清缓慢组、<34%组和<43%组;由此提示动态增强CT表现特征与MVD、VEGF表达存在相关性。另一方面,腺瘤和非腺瘤间MVD和VEGF表达存在显著不同。结论MVD和VEGF可能是导致腺瘤和非腺瘤具有不同的TD曲线类型和廓清率的主要因素之一。.
Objective To investigate the correlation between the characteristics of adrenal adenoma and non-adenomatous angioma [microvessel density (MVD), vascular endothelial growth factor (VEGF)] and dynamic contrast-enhanced CT in order to elucidate its dynamic enhancement mechanism. Methods 42 cases of 46 adrenal masses (23 adenomas, 18 non-adenomas and 5 proliferative nodules) confirmed by surgery and pathology were examined by dynamic contrast-enhanced CT and pathology. Firstly, the dynamic contrast-enhanced CT findings of adrenal adenomas and non-adenomas were evaluated. Then the dynamic contrast-enhanced CT features of the adrenal masses were analyzed. [Time density (TD) curve, Wash rate] and angiogenesis were compared. Results There was a significant difference (P = 0.000) between the type of TD curve of adenoma and non-adenoma and the relative wash-out rate (Washa) and 7-min delay point. The TD curve of adrenal mass was rapidly changed between group A and C and group B, D and E, and Washa ≥ 34% and Washa ≥ 43% 43% of the group MVD, VEGF expression differences were statistically significant (P <0.05). A, C type, and / or Washr ≥ 34HU, and (or) Washa ≥ 43% group were prompted adenoma, and on the contrary prompted non-adenoma. The TD curve was cleared in the rapid group. The MVD and VEGF expression levels in Washre≥34% group and Washa≥43% group were higher than those in slow group, <34% and <43% There is a correlation between the characteristics and MVD and VEGF expression. On the other hand, there is a significant difference in the expression of MVD and VEGF between adenomas and non-adenomas. Conclusions MVD and VEGF may be one of the main factors leading to different TD curve types and clearance rates for adenomas and non-adenomas. .