Relationship between Shear Stiffness Measured by MR Elastography and Perfusion Metrics Measured by Perfusion CT of Meningiomas
Relationship between Shear Stiffness Measured by MR Elastography and Perfusion Metrics Measured by Perfusion CT of Meningiomas
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DOI：
10.3174/ajnr.a7117
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发表时间：
2021-05-13
影响因子：
3.5
通讯作者：
Onishi, H.
中科院分区：
文献类型：
--
作者：
Takamura, T.;Motosugi, U.;Onishi, H.
背景和目的：在处理脑膜瘤时，术中肿瘤的一致性和组织学亚型是影响手术策略的不可或缺的因素。本研究的目的如下：1）研究MR弹性成像评估的刚度与灌注CT灌注度量之间的相关性; 2）评估MR弹性成像和灌注CT是否可以预测术中肿瘤的一致性; 3）探索刚度和灌注度量在区分脑膜瘤组织学亚型中的预测价值。材料和方法：计算14例脑膜瘤患者的平均肿瘤硬度和相对灌注指标（血流量、血容量和MTT）（相对于正常脑组织），这些患者在手术前接受了MR弹性成像和灌注CT（队列1）。由神经外科医生对18例患者（队列2，包括队列1的14例患者和4例其他患者）的术中肿瘤一致性进行分级。在队列1中评价了肿瘤硬度和灌注指标之间的相关性，以及灌注指标预测术中肿瘤一致性和区分组织学亚型的能力。队列2进行了分析的能力，刚度，以确定术中肿瘤的一致性和组织学subtypes.Results：相对MTT与刚度呈负相关（P = 0.006）。肿瘤硬度与术中肿瘤一致性呈正相关（P = 0.01），而灌注指标则不相关。相对MTT显着区分过渡性脑膜瘤脑膜瘤（P = 0.04），而刚度没有显着区分任何组织学subtypes.CONCLUSIONS：在脑膜瘤，肿瘤刚度可能是有用的预测术中肿瘤的一致性，而相对MTT可能与肿瘤刚度和区分过渡性脑膜瘤。
BACKGROUND AND PURPOSE:When managing meningiomas, intraoperative tumor consistency and histologic subtype are indispensable factors influencing operative strategy. The purposes of this study were the following: 1) to investigate the correlation between stiffness assessed with MR elastography and perfusion metrics from perfusion CT, 2) to evaluate whether MR elastography and perfusion CT could predict intraoperative tumor consistency, and 3) to explore the predictive value of stiffness and perfusion metrics in distinguishing among histologic subtypes of meningioma.MATERIALS AND METHODS:Mean tumor stiffness and relative perfusion metrics (blood flow, blood volume, and MTT) were calculated (relative to normal brain tissue) for 14 patients with meningiomas who underwent MR elastography and perfusion CT before surgery (cohort 1). Intraoperative tumor consistency was graded by a neurosurgeon in 18 patients (cohort 2, comprising the 14 patients from cohort 1 plus 4 additional patients). The correlation between tumor stiffness and perfusion metrics was evaluated in cohort 1, as was the ability of perfusion metrics to predict intraoperative tumor consistency and discriminate histologic subtypes. Cohort 2 was analyzed for the ability of stiffness to determine intraoperative tumor consistency and histologic subtypes.RESULTS:The relative MTT was inversely correlated with stiffness (P = .006). Tumor stiffness was positively correlated with intraoperative tumor consistency (P = .01), while perfusion metrics were not. Relative MTT significantly discriminated transitional meningioma from meningothelial meningioma (P = .04), while stiffness did not significantly differentiate any histologic subtypes.CONCLUSIONS:In meningioma, tumor stiffness may be useful to predict intraoperative tumor consistency, while relative MTT may potentially correlate with tumor stiffness and differentiate transitional meningioma from meningothelial meningioma.