Correlation Study About MR-PWI With Pathological Angiogenesis In Musculoskeletal Tumor

Objective To explore the applications of MR-Perfusion weighted imaging(MR-PWI) and angiogenic factors in the benign and malignant primary musculoskeletal tumors and to explore the correlation between the perfusion parameters and tumor angiogenic factors, so as to evaluate the value of MR-PWI in tumor angiogenesis.Materials and Methods 68 cases of primary musculoskeletal tumors were collected and examined MRI and MR-PWI by GE Signa Excite HDX 3.0T MRI and DSC-MRI before operation.The MR-PWI examination adopted GRE-EPI-T2* sequence, scanning when contrast agent was injected, observe the characters of the perfusion parameters, such as the time-signal intensity cruve(TIC),the negative enhancement integral(NEI),the maximum slope of decrease(MSD),the mean time to enhance(MTE) in the interest ROI region. Then analyze the distribution pattern and the statistical difference of the benign and malignant tumors.After operation, the tumor pathological sections were performed with SP immumohistochemical staining to detect the microvessel density(MVD) and the expression of vascular endothelial growth factor(VEGF) and the statistical difference of them.68 cases of primary musculoskeletal tumors were studied as a whole, using correlation analysis to detect the perfusion parameters with MVD and VEGF to evaluate the value of MR-PWI in tumor angiogenesis.Results After pathology diagnosis, there were 32 cases of benign and 36 cases of malignant among 68 cases of primary musculoskeletal tumors. 1. ①TIC typing: TIC was divided into four types, with type 1 stable, type 2 slow decline and slow rise, type 3 fast decline and slow rise, type4 fast decline and fast rise.TIC distribution: 19 cases of type 1, 10 cases of type 2, 2 cases of type 3, 1 case of type 4 in benign tumors and 1 case of type1, 1 case of type 2, 13 cases of type 3, 21 cases of type 4 in malignant tumors. There is statistical difference between the benign and malignant tumors TIC typing and distribution(X2 =49.749,p<0.01).②The NEI and MSD(147.12±48.8;81.29±36.87) of malignant tumors were higher than the benign tumors(35.39±19.75;21.62±19.8), with statistical significance between the benign and malignant tumors(t=12.622,p<0.01;t=8.436,p<0.01).The MTE was overlapped between the benign and malignant tumors, without statistical significance(t=0.175,p>0.05). 2.The MVD of malignant group(22.46±5.77) was higher than the benign ones(13.4±4.16), with statistical significance(t=7.344,p<0.01).The expression of VEGF of malignant group was higher than the benign group, with statistical significance(Z=-5.68,p<0.01). 3.The NEI and MSD had positive correlation with MVD(p<0.01), with r valued 0.623,0.601.MTE had no significant correlation with MVD(r=-0.014,p>0.05).The NEI and MSD had significant positive correlation with VEGF(p<0.01), with r valved 0.635,0.698.MTE had no significant correlation with VEGF(r=-0.135,p>0.05).Conclusion The TIC typing and part of the perfusion parameters of MR-PWI and tumor angiogenic factors can be used to improve the specificity of primary musculoskeletal tumors’ s diagnosis and differential diagnosis.MR-PWI can evaluate micro-vasculogenesis of musculoskeletal tumors, and has a certain value in evaluating the angiogenesis of musculoskeletal tumors in vivo.It can provide reliable information about microcirculation changes for clinical preoperation and prognostic.