The Clinical Pathologic Control Study On Breast Cancer Between Multidetector-Row Spiral CT Perfusion Imaging And Angiogenesis

Objective:To study the characters of Multidetector-Row Spiral Computed Tomography(MSCT)perfusion imaging in Breast cancer, breast benign tumors and normal breast.Methods:There were 38 patients including 27 breast cancer and 11 benign breast tumor.A conventional breast MSCT scan was obtained as a routine to locate the breast lesions.Dynamic scans were performed at the location of the lesions with 50 ml of nonionic contrast administration (300 mgI/ml)at the speed of 6 ml/s.Data postprocessing was performed on Siemens workstation using tumor analyzing software in the package of Body Perfusion.Pseudo-color perfusion images were gained,so as to the time-density curve(TDC)and perfusion parameters by region of interest(ROI)evaluation.Chi-Square Tests,Independent Samples T-Test and Paired Samples T-Test were applied to compare the TDC type and perfusion parameter values of breast cancer,breast benign tumors and normal breast.Perfusion parameters include maximum intensity projection(MIP),average value(AV),blood flow(BF),blood volume(BV), time to start(TTS),time to peak(TTP),permeability surface(PS),Patlak blood volume(PBV).Results:The TDC of normal breast tissues were flat-type.76.47%, 71.43%breast tumors with outflow-type or platform-type TDC were breast cancer,while 85.72%breast tumors with inflow-type were benign. The means of BF,BV,PS and PBV in breast cancer were 63.934±36.918 ml/100ml/min,8.471±3.440 ml/100ml,19.522±10.873 ml/100ml/min, 13.293±10.216 ml/100ml respectively.The means of BF,BV,PS and PBV of breast cancer were higher than those of benign breast tumor and normal breast,while the means of TTP and TTS among breast cancer, benign tumor and normal breast have no significant difference.The means of AV,BF,BV and PBV of center zone were lower than those of boundary zone in breast cancer,while the means of BF,BV and PBV of center zoon were higher than those of boundary zone in benign breast tumors.Conclusion:There are different MSCT perfusion characters among breast cancer,benign breast tumor and nomal breast,which are helpful to differentiate the breast cancer or benign breast tumors and to orientate in biopsy.PartⅡ:Study on relation between MSCT perfusion imaging and angiogenesis in breast cancerObjective:To research the relation between MSCT perfusion imaging and angiogenesis of breast cancer.Materials and Methods:The cases in this part were the same with PartⅠ.The microvessel density(MVD)and vascular endothelial growth factor(VEGF)of the tissues from 28 breast cancer,26 paracarcinoma breast tissues and 25 benign breast tumors were detected by immunohistochemistry technology."Hotpoint" was used to count the MVD,the cumulation of staining intensity and positive cell ratio was used to count VEGF.The CT perfusion parameter values and MVD, VEGF were put in SPSS11.5 to gain the "scatterplot graph" and the correlation coefficients.Results:Expression of MVD and VEGF were detected in tissues of breast cancer,benign breast tumors and paracarcinoma breast tissues. MVD and VEGF of breast tumor tissues had positive relation statistically and the Spearman rank correlation coefficient was 0.815.Expression of MVD and VEGF of breast cancer tissue were statistically higher than those of benign breast tumors and paracarcinoma breast tissues.The means of MVD and VEGF in outflow-type and platform-type time-density curve were statistically higher than that in inflow-type and flat-type of breast tumors.MIP,AV,BF,BV,PS and PBV of breast cancer had positive relation statistically with MVD,the Pearson correlation coefficients were 0.441,0.457,0.501,0.493,0.523,0.473.Conclusion:MVD and VEGF of breast tumor tissue have positive relation statistically.Breast cancer and benign breast tumor have different angiogenesis.Multidetector-Row Spiral CT perfusion imaging can detect and represent the angiogenesis of breast cancer.The perfusion parameter values have close relation with MVD of breast cancer.The technology is a convenient,sensitive and correct method to detect breast cancer angiogenesis.