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经皮肌肉活检致组织损伤的活体可视化:一种新型高分辨率磁共振成像技术。

In Vivo Visualization of Tissue Damage Induced by Percutaneous Muscle Biopsy via Novel High-Resolution MR Imaging.

机构信息

Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, GERMANY.

Department of Sports Medicine (Internal Medicine VII), Medical Clinic, Heidelberg University Hospital, Heidelberg, GERMANY.

出版信息

Med Sci Sports Exerc. 2021 Jul 1;53(7):1367-1374. doi: 10.1249/MSS.0000000000002601.

Abstract

PURPOSE

Percutaneous muscle biopsy is the gold standard for tissue assessment in clinical practice and scientific studies. The aim of this study was to assess and quantify the ensuing tissue damage by in vivo magnetic resonance imaging (MRI).

METHODS

In this prospective study, we enrolled 22 healthy participants who underwent MRI of the thigh musculature about 1 wk after a percutaneous muscle biopsy of the vastus lateralis muscle. A total of 17 participants also volunteered for a second MR examination 2 wk after biopsy. Volumes of susceptibility-weighted imaging (SWI) lesions and muscle edema were assessed by SWI and T2-weighted MRI, respectively, after manual segmentation by two independent readers. For quantitative in vivo hematoma volume assessment, we additionally determined signal changes induced by experimental hematoma in an ex vivo model.

RESULTS

Mean overall volume of SWI lesions 1 wk after biopsy was 26.5 ± 21.7 μL, accompanied by a mean perifocal edema volume of 790.1 ± 591.4 μL. In participants who underwent two examinations, mean volume of SWI lesions slightly decreased from 29.8 ± 23.6 to 23.9 ± 16.8 μL within 1 wk (P = 0.13). Muscle edema volume decreased from 820.2 ± 632.4 to 359.6 ± 207.3 μL at the same time (P = 0.006). By calibration with the ex vivo findings, signal alterations on SWI corresponded to a blood volume of approximately 10-50 μL.

CONCLUSIONS

Intramuscular hematoma and accompanying muscle edema after percutaneous biopsy are small and decrease rapidly within the first 2 wk. These in vivo findings underline the limited invasiveness of the procedure.

摘要

目的

经皮肌肉活检是临床实践和科学研究中组织评估的金标准。本研究旨在通过体内磁共振成像(MRI)评估和量化由此产生的组织损伤。

方法

在这项前瞻性研究中,我们招募了 22 名健康参与者,他们在股外侧肌经皮肌肉活检后约 1 周接受了大腿肌肉的 MRI 检查。共有 17 名参与者还自愿在活检后 2 周进行第二次 MRI 检查。两名独立的读者通过手动分割分别评估了磁敏感加权成像(SWI)病变和 T2 加权 MRI 上的肌肉水肿体积。为了进行定量的体内血肿体积评估,我们还在离体模型中确定了实验性血肿引起的信号变化。

结果

活检后 1 周时,SWI 病变的总体平均体积为 26.5±21.7 μL,伴有平均周围水肿体积为 790.1±591.4 μL。在接受两次检查的参与者中,SWI 病变的平均体积在 1 周内从 29.8±23.6 略微减少到 23.9±16.8 μL(P=0.13)。肌肉水肿体积同时从 820.2±632.4 减少到 359.6±207.3 μL(P=0.006)。通过与离体结果校准,SWI 上的信号改变对应于约 10-50 μL 的血容量。

结论

经皮活检后肌内血肿和伴随的肌肉水肿较小,在最初的 2 周内迅速减少。这些体内发现强调了该程序的微创性。

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