中文摘要：

目的 分析不同级别胶质瘤的MR氨基质子转移（APT）成像及病理特征,探讨APT成像可能的病理学基础.方法 回顾性分析经手术病理证实的胶质瘤患者28例,包括11例低级别（低级别组）与17例高级别胶质瘤（高级别组）,进行常规扫描及APT扫描,手术标本采用常规HE染色、CD34及细胞增殖抗原（Ki-67）免疫组织化学染色检查.采用两独立样本t检验分析高级别组与低级别组瘤核心APT值、肿瘤细胞密度、微血管密度（MVD）及肿瘤增殖标记指数的差异,采用Pearson相关性分析肿瘤核心APT值与肿瘤细胞密度、MVD及肿瘤增殖标记指数之间的相关性,多元线性回归分析APT值与三者之间的关系.结果 低级别组及高级别组瘤核心的APT值分别为（2.3±0.6）％、（3.6±0.7）％,肿瘤细胞密度分别为（9.4±2.4）％、（18.4±4.7）％,MVD分别为（19.0±7.4）、（38.9±11.3）条/高倍视野,肿瘤增殖标记指数分别为（14.2±5.4）％、（31.7±4.5）％,高级别组各指标高于低级别组,差异均有统计学意义（t值分别为-4.94、-5.89、-5.13、-9.28,P值均＜0.01）.高、低级别肿瘤瘤核心的APT值与肿瘤细胞密度、MVD及肿瘤增殖指数呈显著正相关（r值分别为0.904、0.598、0.750,P值均＜0.01）.且瘤核心的APT值（Y）与肿瘤细胞密度（X1）、MVD（X2）及肿瘤增殖指数（xO之间呈多元线性相关,方程为Y=0.801＋ 0.12X1-0.003X2＋ 0.026X3 （F=46.437,P＜0.01,R2=0.853）.结论 脑胶质瘤APT成像能反映其病理学特征,胶质瘤瘤核心的APT值越大,肿瘤细胞密度、MVD、肿瘤增殖指数越高,肿瘤级别越高.

英文摘要：

Objective To investigate the probable pathologic basis of amido proton transfer（APT） imaging by analysing APT signal intensity and pathologic features of different grades of glioma.Methods Twenty-eight patients with glioma confirmed by postoperative pathology underwent APT scan.All the patients were divided into two groups,including 11 cases in low grade （WHO Ⅰ and Ⅱ） and 17 cases in high grade （WHO Ⅲ and Ⅳ） group.The APT rate of tumor core was measured.The specimens were processed with routine hematoxylin-eosin （HE） staining and immunohistochemistry of Ki-67 and CD34.Independent-samples t test was used to detect the difference of APT rate,cellularity,microvessel density and Ki-67 labeling indices of tumor core between low grade and high grade group.Pearson correlation analysis and multi-variable linear regression analysis were used to detect the relationship of APT rate with cellularity,microvessel density and Ki-67 labeling indices of the tumor core.Results The APT rate,cellularity and proliferation index were （2.3±0.6） ％,（9.4±2.4） ％ and （14.2±5.4） ％ in low grade group,while （3.6±0.7） ％,（18.4±4.7） ％ and （31.7±4.5） ％ in high grade group,respectively.Microvessel density was （19.0±7.4） per high-power field in low grade group and （38.9±11.3） in high grade group.There were statistical differences of the APT rate,cellularity,microvessel density and proliferation index between the low grade group and the high grade group （t=-4.94,-5.89,-5.13,and-9.28,respectively,P＜0.01）.The APT rate was positive correlated with cellularity,microvessel density and proliferation index.The coefficient of correlation were 0.904,0.598,and 0.750,respectively,（P＜0.01）.Multiple linear correlative analysis showed that increasing cellularity （X1）,microvessel density （X2） and proliferation index （X3） were the main factors for increasing APT rate,and the correlation equation was Y=0.801 ＋ 0.12X1-0.003X2 ＋ 0.026X3 （F=46.437,P＜0.01,R2=0.853?