The Value Of DCE-MRI Combined With DSC-MRI In The Grading Diagnosis Of Glioma And Its Correlation With Ki-67 And MVD Expression

Objective: The growth of brain glioma(BG)is diffuse infiltrating and microangiogenes-is is one of the main stimuli.In this study,dynamic contrast enhancement(DCE)MRI and dynamic magnetic sensitivity contrast enhancement(DSC)MRI were applied.To investigate the MR Perfusion characteristics of gliomas of different grades and to study the correlation between perfusion parameters and histopathologic grades including Ki-67 and microvessel density(MVD).Materials and Methods:41 patients with glioma,including 28 patients with high grade glioma(HGG)and 13 patients with low grade glioma(LGG),who underwent dynamic contrast enhancement(DCE)MRI and dynamic magnetic sensitivity contrast enhancement(DSC)MRI scanning were enrolled.The values of Ktrans,Ve,Kep,IAUGC,Max Slope derived from DCE and r CBV,r CBF of DSC in tumor parenchyma and peritumoral area(peritumoral < 0.5cm,peritumoral 0.5-1.0cm)were obtained.Ki-67 and MVD in the tumor parenchyma were measured by SP immuno-histochemistry.The t test of two independent samples or Mann Whitney U test were used to compare the differences of perfusion parameters in different areas between groups,and Spearman rank correlation test was used to analyze the correlation between each parameter and Ki-67,MVD and pathological grade.Receiver operating characteristic curves(ROC)were used to evaluate diagnostic efficacy.Results:Compared with LGG group,HGG group had significantly higher values in both tumor and peritumor(peritumor < 0.5cm,peritumor 0.5-1.0cm)(P < 0.05),and r CBV,Ktrans and ktrans had the highest diagnostic efficacy in each region(AUC=0.974,0.880,0.801,respectively).Z=-5.768,-3.895,-3.118,P < 0.001,< 0.001,0.002);Ve+r CBV,Ktrans+r CBF,Ve+r CBV showed the best diagnostic efficacy in each area(AUC=0.984,0.926,0.912,Sensitivity and specificity were 92.3% and 92.9%,84.6% and 96.4%,92.3% and 82.1%,respectively).All the perfusion parameters showed significant moderate or strong positive correlation with Ki-67 and MVD.The correlation between Max Slope,r CBV and Ki-67 and MVD was the strongest for DCE and DSC(r = 0.756 and 0.741;0.726,0.699,P<0.05).Conclusion:Both DCE-MRI and DSC-MRI can reflect the microangiogenesis of glioma in vivo and predict the proliferative activity of tumor cells,furthermore,the combination of both can significantly improve the diagnostic efficiency with complementary advantages.DSC-r CBV has the best diagnostic efficacy in tumor body,while DCEKtrans was in peritumoral area.The combination of DSC-r CBV and DCE-Ktrans can provide comprehensive and non-invasive histological and pathophysiological information for clinical diagnosis and treatment.In addition,LGG microvessels may be the lumen expansion of the original vessels.