利用粘弹性参数的磁共振弹性成像对肝脏局灶性病变进行分类：基于内在和外在激活的初步研究
MR Elastography for Classification of Focal Liver Lesions Using Viscoelastic Parameters: A Pilot Study Based on Intrinsic and Extrinsic Activations.
作者信息
Baradaran Najar Amirhosein, Gilbert Guillaume, Karam Elige, Volniansky Anton, Fohlen Audrey, Barat Maxime, Montagnon Emmanuel, Castel Hélène, Giard Jeanne-Marie, Nguyen Bich N, Cloutier Guy, Tang An, Van Houten Elijah
机构信息
Département de Génie Mécanique, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Laboratoire clinique de traitement de l'image (LCTI), Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada.
出版信息
J Magn Reson Imaging. 2025 Jun;61(6):2525-2540. doi: 10.1002/jmri.29633. Epub 2024 Oct 24.
BACKGROUND
Intrinsic activation MR elastography (iMRE) uses cardiovascular pulsations to assess tissue viscoelastic properties. Applying it to focal liver lesions extends its capabilities.
PURPOSE
To assess the viscoelastic parameters of focal liver lesions measured by iMRE and compare its diagnostic performance with extrinsic MRE (eMRE) for differentiating malignant and benign lesions.
STUDY TYPE
Prospective.
POPULATION
A total of 55 participants underwent MRI with research MRE sequences; 32 participants with 17 malignant and 15 benign lesions underwent both iMRE and eMRE. FIELD STRENGTH/SEQUENCE: iMRE at ~1 Hz heart rate used a 3 T scanner with a modified four-dimensional (4D)-quantitative flow gradient-echo phase contrast and low-velocity encoding cardiac-triggered technique. eMRE employed a gradient-echo sequence at 30, 40, and 60 Hz.
ASSESSMENT
Liver displacements were measured using 4D-phase contrast and reconstructed via a nonlinear inversion algorithm to determine shear stiffness (SS) and damping ratio (DR). iMRE parameters were normalized to the corresponding values from the spleen. Lesions were manually segmented, and image quality was reviewed.
STATISTICAL TESTS
Kruskal-Wallis, Mann-Whitney, Dunn's test, and areas under receiver operating characteristic curves (AUC) were assessed.
RESULTS
SS was significantly higher in malignant than benign lesions with iMRE at 1 Hz (3.69 ± 1.31 vs. 1.63 ± 0.45) and eMRE at 30 Hz (3.76 ± 1.12 vs. 2.60 ± 1.26 kPa), 40 Hz (3.76 ± 1.12 vs. 2.60 ± 1.26 kPa), and 60 Hz (7.32 ± 2.87 vs. 2.48 ± 1.12 kPa). DR was also significantly higher in malignant than benign lesions at 40 Hz (0.36 ± 0.11 vs. 0.21 ± 0.01) and 60 Hz (0.89 ± 0.86 vs. 0.22 ± 0.09). The AUC were 0.86 for iMRE SS, 0.87-0.98 for eMRE SS, 0.47 for iMRE DR, and 0.62-0.86 for eMRE DR.
DATA CONCLUSION
Cardiac-activated iMRE can characterize liver lesions and differentiate malignant from benign lesions through normalized SS maps.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY: Stage 2.
背景
固有激活磁共振弹性成像（iMRE）利用心血管搏动来评估组织的粘弹性特性。将其应用于肝脏局灶性病变可扩展其功能。
目的
评估通过iMRE测量的肝脏局灶性病变的粘弹性参数，并将其与外部磁共振弹性成像（eMRE）鉴别恶性和良性病变的诊断性能进行比较。
研究类型
前瞻性研究。
研究对象
共有55名参与者接受了带有研究性磁共振弹性成像序列的磁共振成像检查；32名患有17个恶性病变和15个良性病变的参与者同时接受了iMRE和eMRE检查。场强/序列：心率约为1Hz时的iMRE使用3T扫描仪，采用改良的四维（4D）定量血流梯度回波相位对比和低速编码心脏触发技术。eMRE采用30Hz、40Hz和60Hz的梯度回波序列。
评估
使用4D相位对比测量肝脏位移，并通过非线性反演算法重建以确定剪切刚度（SS）和阻尼比（DR）。将iMRE参数标准化为脾脏的相应值。手动分割病变，并评估图像质量。
统计检验
评估了Kruskal-Wallis检验、Mann-Whitney检验、Dunn检验以及受试者操作特征曲线（AUC）下的面积。
结果
在1Hz的iMRE检查中，恶性病变的SS显著高于良性病变（3.69±1.31 vs. 1.63±0.45），在30Hz（3.76±1.12 vs. 2.60±1.26kPa）、40Hz（3.76±1.12 vs. 2.60±1.26kPa）和60Hz（7.32±2.87 vs. 2.48±1.12kPa）的eMRE检查中也是如此。在40Hz（0.36±0.11 vs. 0.21±0.01）和60Hz（0.89±0.86 vs. 0.22±0.09）时，恶性病变的DR也显著高于良性病变。iMRE的SS的AUC为0.86，eMRE的SS的AUC为0.87 - 0.98，iMRE的DR的AUC为0.47，eMRE的DR的AUC为0.62 - 0.86。
数据结论
心脏激活iMRE可通过标准化的SS图对肝脏病变进行特征描述并鉴别恶性与良性病变。
证据水平
2级 技术效能：2级
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