The Correlation Between 3D-ASL Perfusion Index And Tumor Grade?MVD?VEGF ?ki-67 In Glioma

ObjectiveTo study the relationship of mean relative cerebral blood flow(rCBF)and microvascular density(MVD),vascular endothelial growth factor(VEGF)and cell proliferation index Ki-67 in tumors by three-dimensional arterial spin labeling(3D-ASL)magnetic resonance imaging.To evaluate the value of 3D-ASL in the diagnosis of glioma gradingMaterials and methods1?Case data:From May 2018 to January 2019,We collect 27 glioma patients confirmed by pathology,aged 31-62 years,mean age 43.58+12.47 years,17 males and 10 females.All patients underwent MRI plain scan,enhancement and 3D-ASL examinations.Pathological diagnosis and grading of all cases are clear.2?Inspection methods and image post-processingMRI scans were performed on the GE Discovery MR 7503.0T magnetic resonance scanning machine.Routine brain magnetic resonance plain scan,enhancement and 3D-ASL examination were performed before operation in all the patients.3D-ASL labeling delay(PLD)=1525ms.GE(AW4.6 workstation)Functiontool software of 3D-ASL was used for image analysis,adjusting the appropriate threshold,reducing background noise,so that brain tissues were covered in the observation range,and brain perfusion imaging was generated.The region of interest(ROI)was placed in the solid part of the tumor by hotspot method.The area of ROI was about 40-60 mm~2.The gray matter of the contralateral cerebral hemisphere was used as the reference for standardization.The blood flow of the gray matter area in the same layer as ROI was measured three times.The average value of the relative maximum blood flow(rCBF)of the tumors was calculated,such as:rCBF=CBF of the maximum perfusion area of the tumor/CBF of the contralateral cerebral hemisphere was 100%.3?Immunohistochemical detection and result analysis of MVD,VEGF and Ki-67expressionThe expression of MVD,VEGF and Ki-67 in glioma tissue was detected by immunohistochemical Streptomyces antibiotic protein-peroxidase ligation(S-P)method,using CD31 monoclonal antibodies,VEGF and Ki-67 monoclonal antibodies.The densest parts of cells of MVD,VEGF and Ki-67 were selected,and the percentage of positive cells was measured.MVD was counted by Weidner method.4?Statistical analysisSPSS 19.0 statistical software was selected for analysis.The orthodox distribution and homogeneity test of variance were carried out for each group.Spearman correlation analysis was performed for analysing the relationship between rCBF and glioma grade,MVD,VEGF,Ki-67 expression,and P<0.05 was statistically significant.Result1?3D-ASL perfusion imaging features of gliomaThe rCBF of gliomas with different because of pathological types is different.With the increase of malignancy,the rCBF of gliomas tends to increase.Although some low-grade and high-grade tumors have cross-correlation,and even some high-grade tumors have perfusion values equal to or lower than low-grade tumors,most high-grade tumors have higher rCBF than low-grade tumors.The rCBF value of the lower grade group was significantly lower than that of the higher grade group(t=6.49,P<0.001).2?Analysis of correlation between rCBF value and pathological grade of glioma AS the grade of glioma increases,the blood perfusion value of tumor parenchyma also increases.There was a positive correlation between the rCBF value of tumor parenchyma and the pathological grade of glioma(r=0.590,P=0.001).3?Analysis of correlation between rCBF value and expression of MVD,VEGF and Ki-67 in glioma With the increase of perfusion blood flow in glioma,the expression of MVD,VEGF and Ki-67 increased.The expression of MVD,VEGF and Ki-67 in glioma was significantly different from that in the parenchyma of glioma(P<0.05),and there was a positive correlation between rCBF and the expression of MVD,VEGF and Ki-67.The R values were 0.770,0.412 and 0.483,respectively.4?Comparison of expression of MVD,VEGF and Ki-67 in high and low grade gliomasMVD and VEGF were mostly low-expressed in low-level group and high-expression in high-level group,but there were some cases with high-expression of MVD and VEGF in low-level group and cases with low-expression of MVD and VEGF in high-level group.The expression of MVD and VEGF in high-level group and low-level group was significantly different(P<0.05).Ki-67 index of low-level glioma was significantly lower(32.6<11.8)than the proliferative index of high grade glioma(53.9+19.2),they had statistical significance(P<0.05).5?Analysis of correlation between grading of glioma and expression of MVD,VEGF and Ki-67With the increase of glioma grade,the indexes of MVD,VEGF and Ki-67 increase There was significant differences in the expression of MVD,VEGF and Ki-67 between glioma grade and pathological indexes(P<0.05),and there was a positive correlation between them.The R values were 0.461,0.398 and 0.583,respectively.Conclusion1?3D-ASL perfusion imaging technology can evaluate the microvascular perfusion of glioma,which has a certain application value for the preoperative grading of glioma.2?The parameters rCBF of 3D-ASL are positively correlated with the pathological parameters MVD,VEGF and Ki-67 of glioma.This technique can reflect the microvascular proliferation and cell proliferation in glioma,and has important guiding significance in evaluating the invasiveness and prognosis of patients.