The Correlation Between MR Perfusion Parameters And Pathologic Characteristics In Uterine Cervix Cancer

Objective: To explore the characteristics of time-signa intensity curve (TIC) in tissues in uterine cervix cancer and normal uterine cervix, and to investigate the relationship between MR perfusion parameters: positive enhancement integral (PEI), maximum slope of increase (MSI), time to peak (TTP), peak height (PH), time of microvascular perfusion dominance (TPD), time of microvascular effusion dominance (TED) and tissue composition, differentiated type, microvessel density (MVD), VEGF expression in uterine cervix cancer.Methods: MR routine scanning and perfusion imaging were performed in Forty-three patients with uterine cervix cancer and twenty-three patients without uterine cervix cancer, Data of the MR perfusion imaging drew into TIC, revised TIC, and derivatized into perfusion parameter (PEI, MSI, PH, TTP, TPD, and TED). The correlation between the respective perfusion parameters and immunohistochemical findings of tissue ingredient, patholo gy type, cell differentiation, MVD measurement and VEGF expression were evaluated. Statistical method used wilcoxon's rank sum test, X~2 test and kappa test.Results: (1) In forty-three patients with uterine cervix cancer and twenty-three patients without uterine cervix cancer, The shapes of TIC and revised TIC of every group of uterine cervix cancer and normal cervix were similar, they showed a obvious steep upslope, a long platform after peak value. Compared to normal uterine cervix group, the upslope in TIC and revised TIC of uterine cervix cancer groups were steeper; (2) among MR perfusion parameters, the median of PEI, MSI, PH and MVD(123.7, 44.5, 320, and 35.2,respectively) in poorly-moderately differentiated group were higher than those(186.5, 50.2, 237, and 55.8, respectively) in well-differentiated group(p=0.0013, 0.0018, 0.0116 and 0.0010, respectively); the median of TTP, TPD, and TED(48.3, 18.0, and 35.8, respe ctively) in poorly-moderately differentiated group were shorter than those((48.3, 18.0, and 35.8, respectively) in well-differentiated group (p=0.0384, 0.0409, and 0.0274, respectively);the median of PEI, MSI, PH and MVD(125.4, 40.3, 302, and 43.5, respectively) in VEGF negative expression group were higher than those(187.2,29.2, 268, and 12.8 , respectively) in VEGF negative expression group (p=0.0087, 0.0351, 0.0125, and 0.0078, respectively); the median of TTP, TPD, and TED(36.2,10.3, and 18.0, respectively) in VEGF positive expression group were shorter than those (50.2, 18.2, and 12.8, respectively) in VEGF negative expression group (p=0.0418, 0.0344, and 0.0281, respectively); the median of PEI, MSI, PH and MVD(267.3, 51.6, 267. and 50.3, respectively) in Cellular Fascicle Dominance group were higher than those((194.6, 32.8, 220, and 10.1, respectively) in Fibrous Stroma Dominance group (p=0.0089,0.0336, 0.0113, and 0.0023, respectively); the median of TTP, TPD, and TED(30.7, 9.5, and 16.8, respectively,) in Cellular Fascicle Dominance group were shorter than those(52.3, 15.0, and 30.8, respectively) in Fibrous Stroma Dominance group (p=0.0207, 0.0307, and 0.0301, respectively); the median of PEI, MSI, PH and MVD(285.6, 53.3, 285, and 63.5, respectively,) in adenous cancer group were higher than those (150.7, 38.7, 208, and 42.1, respectively) in squamous cancer group (p=0.0059, 0.0344, 0.0125, and 0.0012, respectively); the median of TTP, TPD, and TED( 30.8, 9.7, and 16.3, respectively) in cancer group were shorter than those (42.6, 18.5, and 22.6, respectively) in squamous cancer group (p=0.0436, 0.0336, and 0.0436, respectively); the PH value had no difference between the normal cervix group and uterine cervix cancer group ( p=0.0687 ) , PEI, MSI, and MVD in obvious enhancement areas of uterine cervix cancer goup were higher than the ones in those of normal cervix group ( p=0.0010, 0.0013, 0.0010, respectively ) , but TTP, TPD, and TED were shorter(p=0.0250,0.0060,0.0044, respectively ) .Conclusion: TIC and MR perfusion imaging paremeters had correlation with pathologic characteristics in uterine cervix cancer. They could reflect biological behaviour of tissue composition, differentiated type, microvessel density and VEGF expression in uterine cervix cancer in vivo in different levels...