Shear Stiffness of 4 Common Intracranial Tumors Measured Using MR Elastography: Comparison with Intraoperative Consistency Grading
Shear Stiffness of 4 Common Intracranial Tumors Measured Using MR Elastography: Comparison with Intraoperative Consistency Grading
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DOI：
10.3174/ajnr.a4832
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发表时间：
2016-10-01
影响因子：
3.5
通讯作者：
Namba, H.
中科院分区：
文献类型：
--
作者：
Sakai, N.;Takehara, Y.;Namba, H.
背景与目的：颅内肿瘤的硬度影响肿瘤切除的结果。我们利用磁共振弹性成像技术评估了4种常见颅内肿瘤的僵硬度，并测试了磁共振弹性成像是否有可能在术前鉴别坚固性肿瘤。材料和方法：招募34例计划切除的脑膜瘤、垂体腺瘤、前庭神经鞘瘤和胶质瘤患者进行MR弹性成像。在弹性图上，通过在肿瘤上放置ROI来测量平均和最大剪切刚度。在不了解MR弹性成像结果的情况下，外科医生采用5分制对术中肿瘤一致性进行定性评估。采用切除标本进行组织病理学诊断。将平均和最大剪切刚度与组织病理学亚型进行比较，并由外科医生对术中肿瘤一致性进行分级。结果：脑膜瘤的平均和最大剪切刚度分别为1.9 0.8 kPa和3.4 +/- 1.5 kPa，垂体腺瘤为1.2 +/- 0.3 kPa和1.8 +/- 0.5 kPa，前庭神经鞘瘤为2.0 +/- 0.4 kPa和2.7 +/- 0.8 kPa，胶质瘤为1.5 +/- 0.2 kPa和2.7 +/- 0.8 kPa。脑膜瘤的平均和最大剪切刚度高于垂体腺瘤（P < 0.05）。平均和最大剪切刚度与外科医生对肿瘤一致性的定性评估有显著相关性（P < 0.05）。5个瘤组织的最大剪切刚度高于非瘤组织（P < 0.05）。结论：磁共振弹性成像可根据肿瘤剪切刚度的物理性质对其进行评价。磁共振弹性成像可能有助于术前鉴别坚固性肿瘤。
BACKGROUND AND PURPOSE: The stiffness of intracranial tumors affects the outcome of tumor removal. We evaluated the stiffness of 4 common intracranial tumors by using MR elastography and tested whether MR elastography had the potential to discriminate firm tumors preoperatively.MATERIALS AND METHODS: Thirty-four patients with meningiomas, pituitary adenomas, vestibular schwannomas, and gliomas scheduled for resection were recruited for MR elastography. On the elastogram, the mean and the maximum shear stiffnesses were measured by placing an ROI on the tumor. Blinded to the MR elastography findings, surgeons conducted qualitative intraoperative assessment of tumor consistency by using a 5-point scale. Histopathologic diagnosis was confirmed by using the resected specimens. The mean and maximum shear stiffnesses were compared with histopathologic subtypes, and the intraoperative tumor consistency was graded by the surgeons.RESULTS: The mean and maximum shear stiffnesses were the following: 1.9 0.8 kPa and 3.4 +/- 1.5 kPa for meningiomas, 1.2 +/- 0.3 kPa and 1.8 +/- 0.5 kPa for pituitary adenomas, 2.0 +/- 0.4 kPa and 2.7 +/- 0.8 kPa for vestibular schwannomas, and 1.5 +/- 0.2 kPa and 2.7 +/- 0.8 kPa for gliomas. The mean and maximum shear stiffnesses for meningiomas were higher than those of pituitary adenomas (P < .05). The mean and maximum shear stiffnesses were significantly correlated with the surgeon's qualitative assessment of tumor consistency (P < .05). The maximum shear stiffness for 5 firm tumors was higher than that of nonfirm tumors (P < .05).CONCLUSIONS: MR elastography could evaluate intracranial tumors on the basis of their physical property of shear stiffness. MR elastography may be useful in discriminating firm tumors preoperatively.