| The CT perfusion of renal cell carcinoma(RCC) and benign renal tumors were detected by CT perfusion imaging technology and compared each other. Microvessel density (MVD) and Vessel endothelial growth factor(VEGF) of the same groups were detected by immunohistochemistry technology and also compared each other. The relation between the CT perfusion with MVD and VEGF of renal cell carcinoma and the correction, feasibility and practicality of CT perfusion detecting angiogenesis of RCC was discussed.Part I Application of CT Perfusion Imaging on Diagnosing RCCObjective: To study the blood dynamic change of RCC and discuss the value of CT perfusion imaging in diagnosis and differential diagnosis of RCC by detection and study the CT perfusion of renal cell carcinoma(RCC) and benign renal tumors.Materials and methods: 51 patients with renal tumors (39 RCC, 12 benign renal tumors) were studied. Six seconds after 4.0ml/s and 50 ml contrast agent (300mg I/ml) bolus injection, the perfusion scanning of chosen section was performed using Siemens Bodyperfusion. Scanning parameters were 120KV tube voltage, 35 mAs tube current, 1 second acquisition time and 1 second circle time. After perfusion scanning,intravenous injection of 50-60 ml contrast agent was administered at 2.0 ml/s and routine renal scanning was performed. The images of perfusion scanning were transformed to MV300 workstation, and managed with Siemens Perfusion CT/VA11A. Eight pseudocolor perfusion images were gained, so as to the perfusion values by ROI evaluation. One-way ANOVA LSD> SNK and Dunnett's C were applied. Results: Multisection spiral CT (MSCT) is very important for diagnosis of renal tumors, staging before operation, evaluation of resection and follow-up after operation. BodyPerfusion plan can cover 2 cm in dynamically scanning, demonstrating the advantages of MSCT and increasing radiated dosage inevitably. The data gained by Siemens Perfusion CT/VA11A of MIP> Sum Image > Flow> Blood Volume > Flow Without Vessels > Peak Enhancement > Time to Start n Time to Peak of RCC and benign renal tumors were analyzed statistically. The CT perfuskMK Blood Volume ^ MIP> Flow without Vessels >. Peak Enhancement and Sum Image of RCC were higher than those of benign renal tumors, while the Time to Start was lower. The CT perfusion of metastatic RCC was higher than those of the unmetastatic. Pseudocolor perfusion images were convenient to investigate the CT perfusion and had limited value for qualitative diagnosis.Conclusion: Different renal tumors had different CP perfusion. CT perfusion imaging could detect the blood dynamic change of differentrenal tumors, which was helpful to differentiate the malignant or benign renal tumors. The CT perfusion of metastatic RCC was higher than those of the unmetastatic, suggesting the close relation between CT perfusion with metastasis. But this result needed further study because the number of the case with metastatic RCC was no enough to analyze statistically. Pseudocolor perfusion images were convenient to investigate the CT perfusion and had limited value for qualitative study.Part II StudyofAngiogenesisofRCCObjective: To investigate and analyze angiogenesis of RCC through detection MVD and VEGF of RCC and benign renal rumors. Materials and methods: The cases in this part were the same with Part I . The MVD and VEGF of the tissues of 39 RCC and 39 paracarcinoma renal tissues and 12 tissues of benign renal tumors were detected by immunohistochemistry technology. "Hotpoint" was used to count the MVD, and the product of staining intensity and positive cell ratio was used to count VEGF. Data were analyzed statistically by T-test and Bivariate correlations.Results: Expression of MVD and VEGF was detected in tissues of RCC and benign renal tumors and paracarcinoma renal tissues. Expression of MVD and VEGF of RCC tissue was statistically higher than that of benign renal tumors and paracarcinoma renal tissues. MVD and VEGF of RCC tissue had positive relation statistically.Conclusion: Different renal tumors had different angiogenesis. MVD and VEGF had close relation with growth and transfer of RCC. MVD and VEGF of RCC tissue had positive relation statistically.Part ID Study of relation between CT perfusion with angiogenesis of RCCObjective: To research relation between CT perfusion with angiogenesisof RCC and discuss correction, feasibility and practicality of CTperfusion detecting angiogenesis of RCC.Materials and methods: The CT perfusion and MVD and VEGF wereput in SPSS11.0 to gain the "spot graph" and the relation index.Results: MVD and VEGF of RCC tissue had positive relation statisticallywith CT perfusion, and the relation index was 0.724.Conclusion: CT perfusion imaging could detect and represent theangiogenesis of RCC. CT perfusion imaging technology is a convenient,sensitive and correct methods of detection of tumor angiogenesis.
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