He Siyuan, Zhou Wenwen, Hu Tianyu, Huang Yingqian, Zhu NengJin, Mazu Liwei, Wang Wei, Zhang Nu, He Kejun, Chu Jianping
Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
J Magn Reson Imaging. 2025 Jul 5. doi: 10.1002/jmri.70024.
Tissue stiffness can be evaluated by MR elastography (MRE). As tissue stiffness features similarly affect water diffusion, this assumption needs validation across brain tumors.
To compare MRE and intravoxel incoherent motion (IVIM)-based virtual elastography (vMRE) in assessing the stiffness of gliomas, meningiomas, and schwannomas, and to evaluate associations with intraoperative stiffness, cerebral blood flow (CBF), clinical, and histopathological features.
Prospective.
Sxity patients (63.3% females) with 24 meningiomas, 28 gliomas, and 8 schwannomas.
FIELD STRENGTH/SEQUENCE: 3-T, spin-echo echo-planar imaging (SE-EPI) sequence for MRE and IVIM-based vMRE; arterial spin labeling (ASL).
Quantitative elastography-derived parameters (c, φ from MRE; μ, sADC from vMRE) were extracted from 3D tumor segmentations. Zada grading was evaluated in all cases. CBF was measured by ASL in 36 cases. Immunohistochemistry for collagen, cluster of differentiation 163 (CD163) and hyaluronan binding protein (HABP) was performed in 28 cases.
Bland-Altman plots and intraclass correlation coefficients (ICCs) were used to evaluate inter-reader agreement of elastography-derived parameters. Pearson's coefficients were used to correlate CBF and histopathological markers with elastography-derived parameters. Spearman's coefficients were used to correlate Zada grade with elastography-derived parameters. Group comparisons were performed using one-way ANOVA with Tukey's post hoc test. Receiver operating characteristic (ROC) curve and DeLong's test were performed for stiffness prediction efficiency. p < 0.05 was considered significant.
vMRE parameters significantly correlated with MRE parameters (μ-c: r = 0.635, sADC-c: r = -0.657). μ best predicted intraoperative tumor stiffness and was positively correlated with intraoperative blood loss in meningiomas. μ, φ, and sADC differed by resection extent in meningiomas. Stiffness correlated positively with CBF (in 36 cases), collagen, and CD163 (in 28 cases).
Both MRE and vMRE parameters demonstrated potential for predicting intraoperative tumor stiffness and showed correlation with CBF, collagen deposition, and CD163-positive macrophage infiltration.
组织硬度可通过磁共振弹性成像（MRE）进行评估。由于组织硬度特征对水扩散的影响类似，这一假设需要在脑肿瘤中进行验证。
比较MRE和基于体素内不相干运动（IVIM）的虚拟弹性成像（vMRE）在评估神经胶质瘤、脑膜瘤和神经鞘瘤硬度方面的效果，并评估其与术中硬度、脑血流量（CBF）、临床及组织病理学特征的相关性。
前瞻性研究。
60例患者（63.3%为女性），其中有24例脑膜瘤、28例神经胶质瘤和8例神经鞘瘤。
场强/序列：3-T，用于MRE和基于IVIM的vMRE的自旋回波平面成像（SE-EPI）序列；动脉自旋标记（ASL）。
从3D肿瘤分割中提取定量弹性成像衍生参数（MRE的c、φ；vMRE的μ、标准化表观扩散系数[sADC]）。对所有病例进行Zada分级评估。36例患者通过ASL测量CBF。28例患者进行了胶原蛋白、分化簇163（CD163）和透明质酸结合蛋白（HABP）的免疫组织化学检测。
采用Bland-Altman图和组内相关系数（ICC）评估弹性成像衍生参数的阅片者间一致性。采用Pearson系数将CBF和组织病理学标志物与弹性成像衍生参数进行相关性分析。采用Spearman系数将Zada分级与弹性成像衍生参数进行相关性分析。使用单因素方差分析及Tukey事后检验进行组间比较。采用受试者操作特征（ROC）曲线和DeLong检验评估硬度预测效率。p < 0.05认为具有统计学意义。
vMRE参数与MRE参数显著相关（μ与c：r = 0.635，sADC与c：r = -0.657）。μ最能预测术中肿瘤硬度，且与脑膜瘤术中失血量呈正相关。脑膜瘤中，μ、φ和sADC因切除范围不同而有所差异。硬度与CBF（36例）、胶原蛋白和CD163（28例）呈正相关。
MRE和vMRE参数均显示出预测术中肿瘤硬度的潜力，并与CBF、胶原蛋白沉积及CD163阳性巨噬细胞浸润相关。
2级。
3级。
