Preliminary Study Of Gd-BOPTA Dynamic Contrast-enhanced MRI In The Evaluation Of Tumor Angiogenesis And Pathological Grade In Hepatocellular Carcinoma

Objective:To investigate the correlation between the characteristics of the gadobenate dimeglumine dynamic contrast-enhanced MRI and MVD, the expression level of VEGF、Ang-2in hepatocellular carcinoma, To investigate the correlation between the characteristics of the dynamic gadobenate dimeglumine contrast-enhanced MRI and pathological grade, and explore its value in evaluating angiogenesis and pathological grade of HCC.Methods:30patients with HCC and6normal volunteers were scanned by a3.0T MR system(GE signa HDx, GE Healthcare) with conventional plain protocols, then gadobenate dimeglumine dynamic contrast-enhanced MRI was performed. The images included early arterial phases, middle arterial phase, late aterial phase, portal vein phase, balanced phase and、delayed phase and hepatobiliary phase. The signal intensity value of HCC and hepatic background parenchyma was measured. Calculated semi-quantitative parameters of time-signal intensity curve(TIC):maximum slope of increase(MSI),maximum slope of decrease(MSD),peak value(PK) and peak contrast enhancement ratio(pCER), and tumor-liver contrast-to-noise ratio of plain and hepatobiliary phase. The pathologic diagnosis of HCC was classified into the low-grade, the middle-grade and the high-grade according to Edmondson’s pathologic classification criteria. The expression level of CD34、VEGF and Ang-2protein in thirty hepatocellular carcinoma cases of HCC group pathologically confirmed were detected by immunohistochemistry. The relationship between the semi-quantitative parameters, tumor-liver CNR of hepatobiliary phase and MVD、these angiogenic factors and pathological grade was analyzed.Results:1.The value of MSI, pCER in HCC group were higher than that of normal group(P<0.05), tumor-liver CNR of hepatobiliary phase were significantly higher than that of plain phrase(P<0.01).2.In HCC group, the value of MSI was negatively correlated with pathological grade(r=0.464, P<0.05); the tumor-liver CNR of hepatobiliary phase was significantly negatively correlated with pathological grade(r=0.628, P<0.01).3.In HCC group, the value of MSI was positively correlated with MVD(r=0.42, P<0.05); the tumor-liver CNR of hepatobiliary phase was positively correlated with MVD(r=0.38, P<0.05); The expressed level of VEGF was mild positively correlated with MSI(r=0.380, P<0.05); The expression level of Ang-2was positively correlated with MSI(r=0.380, P<0.05); NO correlation between the expression level of VEGF or Ang-2and tumor-liver CNR of hepatobiliary phase was found.Conclusion:1. The MSI of Gd-BOPTA dynamic contrast-enhanced MRI can reflect the blood supply of the hepatocellular carcinoma, can reflect pathological grade of hepatocellular carcinoma to some degree.2. The tumor-liver CNR of hepatobiliary phase can reflect the pathological grade of hepatocellular carcinoma, can reflect the MVD in hepatocellular carcinoma to some degree.3. To some extent, the MSI combined with tumor-liver CNR of hepatobiliary phase in Gd-BOPTA dynamic contrast-enhanced MRI can reflect MVD and pathology grade of hepatocellular carcinoma. It could be an non-invasive method to evaluate angiogenesis and pathology grade of hepatocellular carcinoma.4. The upregulation of VEGF, Ang-2at the level of protein may play important roles in angiogenesis of hepatocellular carcinoma.