In Vivo Measurement of Brain Tumor Elasticity Using Intraoperative Shear Wave Elastography
In Vivo Measurement of Brain Tumor Elasticity Using Intraoperative Shear Wave Elastography
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DOI：
10.1055/s-0034-1399152
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发表时间：
2016-12-01
影响因子：
3.4
通讯作者：
Tanter, M.
中科院分区：
文献类型：
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作者：
Chauvet, D.;Imbault, M.;Tanter, M.
目的：目的利用剪切波弹性成像（SWE）对活体组织进行刚度评估。这通常用于乳腺、甲状腺和肝脏疾病，但目前还没有关于脑部疾病的数据。我们的目的是用SWE表征正常脑实质和脑肿瘤的弹性。材料和方法：本研究纳入了计划切除脑肿瘤的患者。除标准超声检查外，术中使用超快超声装置测量每个肿瘤及其周围正常脑的弹性。数据是由一名对诊断不知情的研究者收集的。描述性统计、箱形图分析以及操作者内部和操作者之间的重复性分析。结果：纳入63例患者，将其分为脑膜瘤、低级别胶质瘤、高级别胶质瘤和转移瘤4种主要类型。SWE测量的杨氏模量为区分脑肿瘤提供了新的见解：四个亚组的杨氏模量分别为33.1 +/- 5.9 kPa, 23.7 +/- 4.9 kPa, 11.4 +/- 3.6 kPa和16.7 +/- 2.5 kPa。正常脑组织的特点是可重复的平均刚度为7.3 +/- 2.1 kPa。此外，低级别胶质瘤僵硬度与高级别胶质瘤僵硬度差异显著（p = 0.01），正常脑僵硬度与低级别胶质瘤僵硬度差异显著（p < 0.01）。结论：本研究表明，在最常见的脑肿瘤类型中，弹性存在显著差异。有了术中SWE，神经外科医生可能有创新的信息来预测诊断和指导他们的切除。
Purpose: Objective Shear wave elastography (SWE) enabled living tissue assessment of stiffness. This is routinely used for breast, thyroid and liver diseases, but there is currently no data for the brain. We aim to characterize elasticity of normal brain parenchyma and brain tumors using SWE.Materials and Methods: Patients with scheduled brain tumor removal were included in this study. In addition to standard ultrasonography, intraoperative SWE using an ultrafast ultrasonic device was used to measure the elasticity of each tumor and its surrounding normal brain. Data were collected by an investigator blinded to the diagnosis. Descriptive statistics, box plot analysis as well as intraoperator and interoperator reproducibility analysis were also performed.Results: 63 patients were included and classified into four main types of tumor: meningiomas, low-grade gliomas, high-grade gliomas and metastasis. Young's Modulus measured by SWE has given new insight to differentiate brain tumors: 33.1 +/- 5.9 kPa, 23.7 +/- 4.9 kPa, 11.4 +/- 3.6 kPa and 16.7 +/- 2.5 kPa, respectively, for the four subgroups. Normal brain tissue has been characterized by a reproducible mean stiffness of 7.3 +/- 2.1 kPa. Moreover, low-grade glioma stiffness is different from high-grade glioma stiffness (p = 0.01) and normal brain stiffness is very different from low-grade gliomas stiffness (p < 0.01).Conclusion: This study demonstrates that there are significant differences in elasticity among the most common types of brain tumors. With intraoperative SWE, neurosurgeons may have innovative information to predict diagnosis and guide their resection.