Study On Characteristics Of Different Levels Of Meningioma Magnetic Resonance Imaging Of MMP-9and VEGF

Background and PurposeMeningioma is one of the most common benign tumor of the central nervous system, slow growth, high incidence in the40-60years old。The incidence rate between male and female is about1:2, accounting for15%-20%of intracranial tumors. Although majority meningioma have good wins, but2%-10%of meningiomas have malignant growth behavior and Highly recurrent. The informations of Meningioma preoperative correct positioning, qualitative, peritumoral edema (peritumoral brain edema, PTBE) and peritumoral violations are of great significance for the treatment, especially surgical treatment. Imaging detection include MR imaging (magnetic resonance imaging, MRI), CT angiography and skull plain film examination. MRI has a multi-dimensional imaging and high soft tissue resolution, playing a important role in the meningioma diagnosis. With depth study of the relations between meningioma biological behavior and tumor angiogenesis, vascular endothelial growth factor (vascular endothelial growth factor, VEGF) and matrix metalloproteinase protease-9(matrix metalloproteinase-9, MMP-9) affect meningiomaangiogenesis, invasion and peritumoral edema of adjacent tissue.The study has in contrast of the different levels of meningiomas MRI features and VEGF and MMP-9expression, further study of the different meningioma MRI and molecular pathological basis, the relationship between VEGF and TIMP-1and pathologybiological behavior and the MRI in the progress of the different levels of meningioma and clinical, providing the basis for selecting treatment plan and prognosis evaluation.Material and methods38patients with different levels of meningioma patients after surgical treatment in the First Affiliated Hospital of Zhengzhou University, neurosurgery, had been confirmed by pathology.22cases of grade meningioma1,10cases of grade meningiomas Ⅱ, six cases of grade meningiomasⅢ. Using the German SIEMENS superconducting3.0T magnetic resonance imaging system underwent MRI plain and enhanced scan before surgery. Using the3ways of immunohistochemistry and Western-blot to detect meningiomas of different levels of MMP-9and VEGF expression. Meningioma the enhanced degree as1-3points, significantly lower than the ball fat signal1, slightly lower than the ball fat signal2,equal to or higher than the ball fat signal3; The signal strength on T1WI is assessed as1-5points, the signal1is significantly lower than gray matter and the similar cerebrospinal fluid, signal2is slightly lower than the gray matter equal to the gray matter is3signal, slightly higher than the gray matter is4points,higher than the gray matter and close to fat signal is5points; T2WI signal intensity assessed1-5point, significantly lower than the gray matter for1points, slightly lower than the gray matter for2points,3points is equal to the gray matter, slightly higher than the gray matter is4points, higher than gray matter and cerebrospinal fluid signal nearly as5; peritumoral edema their range is divided into four degrees, Ⅲ degree of edema range greater than4cm, Ⅱ degree of edema range2-4cm, I degree of edema0-2cm,0degrees without edema; whether the record lesions envelopecystic vascular flow void sign, with or without dural tail sign and peritumoral infringement.Results1. MRI of38patients with meningiomas qualitative and positioning diagnostic accuracy rate is100%(38/38).2. Different levels meningioma showed equal or slightly hypointense (92.1%, 35/38) on T1WI; equal,slightly higher or mixed with a high signal (89.4%,34/38) on T2WI; injected GD-DTPA enhancement ratio (100%,38/38); peritumoral edema (71%,27/38), Ⅰ degree of edema in14patients, Ⅱ degree of edema in eight patients, Ⅲ degree of edema in5patients; the meningioma cystic rate (7.8%,3/38); meningiomas blood flow empty shadow (15.7%,6/38); dural tail sign (52.6%,20/38); the peritumoral abuse signs (21%,8/38).3. Immunohistochemistry and Western Blot results show:the expression of MMP-9and VEGF significant difference (P<0.05) in all levels of meningiomas. The level Ⅲ meningiomas expression was significantly higher statistically significant than level Ⅱ (P<0.05), grade Ⅱ meningiomas expression was significantly higher statistically significant than grade Ⅰ (P<0.05), but normal meninges and grade Ⅰ have not statistically significant (P>0.05). Lowest expression in normal meningeal tissue, grade Ⅲ meningiomas of MMP-9expression in the highest, MMP-9protein expression levels tended to increase with meningioma level increasing.4. The relationship between MRI performance and meningioma of MMP-9and VEGF expression:meningioma of MMP-9and VEGF expression associated with T1WI, T2WI signal intensity scores, PTBE, degree of enhancement, are not relevant on the presence or absence of peritumoral infringement and subduralThe tail sign. T1WI, T2WI signal strength, PTBE, the degree of enhancement increased with the increase in MMP-9and VEGF expression in the expression level of significant difference (P<0.05), the range has nothing to do with violations of the dural tail sign and peritumoral no significant difference (P>0.05).Conclusion1. MRI and signal characteristics of meningioma, especially T2WI signal, can generally reflect the pathological basis and molecular characteristics of the tumor.2. With the meningioma level increases, MMP-9and VEGF expression corresponding increase. Grade meningiomas Ⅲ is the highest in the expression of MMP-9and VEGF.3. The meningioma high expression of MMP-9and VEGF promote PTBE formation, with a synergistic effect on tumor proliferation and infiltration.4. Meningiomas of MMP-9and VEGF expression associated with TIWI and T2WI signal intensity ratings, PTBE, and enhance the degree of correlation, are not relevant on the presence or absence of peritumoral infringement and subdural The tail sign.