MR elastography of the brain and its application in neurological diseases.
MR elastography of the brain and its application in neurological diseases.
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DOI：
10.1016/j.neuroimage.2017.10.008
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发表时间：
2019-02-15
期刊：
影响因子：
5.7
通讯作者：
Ehman RL
中科院分区：
文献类型：
--
作者：
Murphy MC;Huston J 3rd;Ehman RL
磁共振弹性成像(MRE)是一种无创性和定量评估组织硬度的成像技术，类似于触诊。磁共振成像能够进一步评估包括大脑在内的手工无法触及的组织的机械特性。这项技术分为三个步骤，首先是通过施加外部振动将横波引入感兴趣的组织。接下来，使用具有与振动同步的运动编码梯度的相衬MR脉冲序列对所得到的运动进行成像。最后，对测量的位移图像进行数学倒置，以计算估计刚度的映射图。在大脑中，这项技术表现出很强的重测重复性，在测量整体硬度方面的典型误差为1%，在测量大脑叶硬度方面的典型误差为2%，在测量皮质下灰质的硬度方面的典型误差为3-7%。在健康的志愿者中，多项研究已经证实，僵硬程度随着年龄的增长而减少，而最近的研究表明，粘弹性和行为表现之间存在很强的联系。此外，一些研究已经证明了大脑僵硬对神经退化的敏感性，因为在多发性硬化症和几种形式的痴呆症中，僵硬已经被证明是减少的。此外，僵硬变化的空间模式在这些不同类别的痴呆症中也不同。最后，MRE是一种有前景的术前评估颅内肿瘤的工具，因为它可以测量肿瘤的一致性和与周围组织的粘附性。这些因素是手术难度的重要预测因素。简而言之，MRE展示了在许多神经疾病中的潜在价值。然而，仍有重大机会进一步完善这项技术，更好地了解潜在的生理学。
Magnetic resonance elastography (MRE) is an imaging technique for noninvasively and quantitatively assessing tissue stiffness, akin to palpation. MRE is further able assess the mechanical properties of tissues that cannot be reached by hand including the brain. The technique is a three-step process beginning with the introduction of shear waves into the tissue of interest by applying an external vibration. Next, the resulting motion is imaged using a phase-contrast MR pulse sequence with motion encoding gradients that are synchronized to the vibration. Finally, the measured displacement images are mathematically inverted to compute a map of the estimated stiffness. In the brain, the technique has demonstrated strong test-retest repeatability with typical errors of 1% for measuring global stiffness, 2% for measuring stiffness in the lobes of the brain, and 3–7% for measuring stiffness in subcortical gray matter. In healthy volunteers, multiple studies have confirmed that stiffness decreases with age, while more recent studies have demonstrated a strong relationship between viscoelasticity and behavioral performance. Furthermore, several studies have demonstrated the sensitivity of brain stiffness to neurodegeneration, as stiffness has been shown to decrease in multiple sclerosis and in several forms of dementia. Moreover, the spatial pattern of stiffness changes varies among these different classes of dementia. Finally, MRE is a promising tool for the preoperative assessment of intracranial tumors, as it can measure both tumor consistency and adherence to surrounding tissues. These factors are important predictors of surgical difficulty. In brief, MRE demonstrates potential value in a number of neurological diseases. However, significant opportunity remains to further refine the technique and better understand the underlying physiology.
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