磁共振弹性成像在常见颅内肿瘤质地评估中的应用OA

[Objective]To explore the clinical potential of magnetic resonance elastography(MRE)for assessing the stiffness of common intracranial tumors.[Methods]A retrospective analysis was conducted on 47 patients with brain tumors who underwent surgical treatment at The First Affiliated Hospital of Sun Yat-sen University between April 2023 and September 2024.The cohort included 10 cases of glioma,12 cases of vestibular schwannoma,and 25 cases of meningioma.All patients underwent multiparameter MRI and MRE preoperatively.After co-registering MRE images with contrast-enhanced 3D T1-weighted images,three regions of interest(ROIs)were placed in the areas of maximum and minimum tumor stiffness respectively to measure the shear stiffness values,and the mean was calculated as the average shear stiffness.Additionally,one ROI was placed in the white matter and one in the grey matter of the posterior horn of the lateral ventricle at the basal ganglia level to obtain normal reference values.A neurosurgeon,blind to the MRE results,graded the intraoperative tumor stiffness based on surgical videos using a 5-point scale(1:soft;5:hard).Intraclass correlation coefficient(ICC)was used to assess inter-observer consistency.Analysis of variance(ANOVA)and nonparametric tests were employed to compare the differences of shear stiffness values between groups.Spearman correlation analysis was used to examine the correlation between elasticity values and clinicopathological parameters.The discriminatory efficacy of shear stiffness values for tumor types was evaluated with receiver operating characteristic(ROC)curves.[Results]The ICCs for elasticity values measured by two physicians in the hardest and softest tumor areas were 0.868 and 0.831,respectively(both P＜0.01).The maximum,minimum,and average shear stiffness values of meningiomas[(1.91±0.28)m/s,(1.66±0.25)m/s,(1.78±0.26)m/s,respectively]were significantly higher than those of gliomas[(1.59±0.23)m/s,(1.42±0.23)m/s,(1.50±0.22)m/s,respectively(P＜0.05)].The shear stiffness values of vestibular schwannomas[(1.70±0.30)m/s,(1.51±0.23)m/s,(1.61±0.26)m/s,respectively)were lower than those of meningiomas and higher than those of gliomas,but these differences were not statistically significant(both P＞0.05).The shear stiffness values of white matter were significantly higher than that of grey matter[(1.63±0.08)m/s vs.(1.39±0.12)m/s,P＜0.05)].In the overall sample,the maximum,minimum,and average shear stiffness values were significantly positively correlated with the intraoperative hardness grade(rs=0.591,rs=0.541,rs=0.571,respectively;all P＜0.001),negatively correlated with WHO grade(rs=-0.458,rs=-0.458,rs=-0.480,respectively;all P＜0.01),but showed no correlation with Ki-67(all P＞0.05).[Conclusion]MRE can be used to assess the stiffness of intracranial tumors and to some extent differentiate between tumor types,which aids in formulating more individualized preoperative surgical plans.