-
人体组织的硬度或者弹性很大程度上取决于组织的分子构成以及这些分子构成在微观和宏观上的组织形式,是组织物理性质中一种重要的机械力学参数,与其生物学特性紧密相关[1]。肿瘤组织尤其是恶性肿瘤组织中常存在大量的细胞外基质,质地硬度明显高于周围正常组织。了解肿瘤组织的硬度对于肿瘤组织局部浸润、远处转移、放化疗抵抗以及手术方式的选择具有重要的作用[2]。
弹性成像,又称为“影像触诊”,最早在1991年由Ophir等[3]提出,可反映组织的硬度。弹性成像首先被用于超声方面,但是超声弹性成像由于主观影响较大、无统一的操作规范等对检测组织弹性程度的评估准确性欠佳。磁共振弹性成像(magnetic resonance elastography,MRE)作为评估软组织硬度的成像技术于1995年产生[4],因其具有安全、可行、无创等特点,目前已经被用于乳腺、前列腺、脑、肝脏、胰腺等肿瘤的研究。
磁共振弹性成像技术在肿瘤中的应用及研究进展
Application and research progress of magnetic resonance elastography in cancer
-
摘要: 肿瘤组织的硬度与肿瘤的发展、浸润、远处转移、放化疗抵抗以及手术方式的选择密切相关,因此准确评估肿瘤组织硬度对于肿瘤的诊断、手术方式的选择及预后评估具有重要意义。磁共振弹性成像是通过机械波定量测量组织弹性剪切力的动态成像方法。磁共振弹性成像作为一种非侵入性的技术可以定量分析在体组织的机械性能(硬度)。它是传统触诊机械化、定量化的一种手段,不仅客观且分辨率高,又不受诊断部位的限制,因此具有良好的研究和应用前景。笔者将综述目前磁共振弹性成像的原理以及其在乳腺、前列腺、脑、肝脏及胰腺等肿瘤中的应用和研究进展。Abstract: Tumor stiffness is closely related with tumor growth, invasion, distant metastasis, radiotherapy and chemotherapy resistance, and the choice of operation. Therefore, accurate evaluation of tumor stiffness is of great significance for the diagnosis of tumor, the choice of operation, and prognosis evaluation of tumor. Magnetic resonance elastography (MRE) is a dynamic imaging method for quantitative analysis of tissue elastic shear force by mechanical wave. It is a method to quantify the mechanical properties (stiffness) of cancer in vivo. It is objective, high-resolution, and can be used in many organs. Therefore, it has potential research value and applied foreground. This article reviews the principle of MRE and the application in cancer of breast, prostate, brain, liver, and pancreas.
-
Key words:
- Elasticity imaging techniques /
- Neoplasms /
- Cancer stiffness /
- Shear wave
-
[1] Sarvazyan AP, Skovoroda AR, Emelianov SY, et al. Biophysical Bases of Elasticity Imaging[J]. Springer US, 1995: 223−240. DOI: 10.1007/978−1−4615−1943−0_23. [2] Lu P, Weaver VM, Werb Z. The extracellular matrix: a dynamic niche in cancer progression[J]. J Cell Biol, 2012, 196(4): 395−406. DOI: 10.1083/jcb.201102147. [3] Ophir J, Céspedes I, Ponnekanti H, et al. Elastography: a quantitative method for imaging the elasticity of biological tissues[J]. Ultrason Imaging, 1991, 13(2): 111−134. DOI: 10.1177/016173469101300201. [4] Muthupillai R, Lomas DJ, Rossman PJ, et al. Magnetic resonance elastography by direct visualization of propagating acoustic strain waves[J]. Science, 1995, 269(5232): 1854−1857. DOI: 10.1126/science.7569924. [5] Lee Yj, Lee JM, Lee JE, et al. MR elastography for noninvasive assessment of hepatic fibrosis: Reproducibility of the examination and reproducibility and repeatability of the liver stiffness value measurement[J]. J Magn Reson Imaging, 2014, 39(2): 326−331. DOI: 10.1002/jmri.24147. [6] Li QS, Lee GY, Ong CN, et al. AFM indentation study of breast cancer cells[J]. Biochem Biophys Res Commun, 2008, 374(4): 609−613. DOI: 10.1016/j.bbrc.2008.07.078. [7] Suresh S. Biomechanics and biophysics of cancer cells[J]. Acta Biomater, 2007, 3(4): 413−438. DOI: 10.1016/j.actbio.2007.04.002. [8] Lorenzen J, Sinkus R, Biesterfeldt M, et al. Menstrual-cycle dependence of breast parenchyma elasticity: estimation with magnetic resonance elastography of breast tissue during the menstrual cycle[J]. Invest Radiol, 2003, 38(4): 236−240. DOI: 10.1097/01.RLI.0000059544.18910.BD. [9] McKnight AL, Kugel JL, Rossman PJ, et al. MR elastography of breast cancer: preliminary results[J]. AJR Am J Roentgenol, 2002, 178(6): 1411−1417. DOI: 10.2214/ajr.178.6.1781411. [10] Lorenzen J, Sinkus R, Lorenzen M, et al. MR elastography of the breast:preliminary clinical results[J]. Rofo, 2002, 174(7): 830−834. DOI: 10.1055/s−2002−32690. [11] Balleyguier C, Lakhdar AB, Dunant A, et al. Value of whole breast magnetic resonance elastography added to MRI for lesion characterization[J/OL]. NMR Biomed, 2018, 31(1)[2018-06-24]. https://onlinelibrary.wiley.com/doi/full/10.1002/nbm.3795. DOI: 10.1002/nbm.3795. [12] Chopra R, Arani A, Huang Y, et al. In vivo MR elastography of the prostate gland using a transurethral actuator[J]. Magn Reson Med, 2009, 62(3): 665−671. DOI: 10.1002/mrm.22038. [13] Arani A, Plewes D, Chopra R. Transurethral prostate magnetic resonance elastography: prospective imaging requirements[J]. Magn Reson Med, 2011, 65(2): 340−349. DOI: 10.1002/mrm.22633. [14] Sahebjavaher RS, Baghani A, Honarvar M, et al. Transperineal prostate MR elastography: Initial in vivo results[J]. Magn Reson Med, 2013, 69(2): 411−420. DOI: 10.1002/mrm.24268. [15] Li S, Chen M, Wang W, et al. A feasibility study of MR elastography in the diagnosis of prostate cancer at 3.0 T[J]. Acta Radiol, 2011, 52(3): 354−358. DOI: 10.1258/ar.2010.100276. [16] Sahebjavaher RS, Nir G, Honarvar M, et al. MR elastography of prostate cancer: quantitative comparison with histopathology and repeatability of methods[J]. NMR Biomed, 2015, 28(1): 124−139. DOI: 10.1002/nbm.3218. [17] Kruse SA, Rose GH, Glaser KJ, et al. Magnetic resonance elastography of the brain[J]. Neuroimage, 2008, 39(1): 231−237. DOI: 10.1016/j.neuroimage.2007.08.030. [18] Hughes JD, Fattahi N, Van Gompel J, et al. Higher-Resolution Magnetic Resonance Elastography in Meningiomas to Determine Intratumoral Consistency[J]. Neurosurgery, 2015, 77(4): 653−658. DOI: 10.1227/NEU.0000000000000892. [19] Murphy MC, Huston J III, Glaser KJ, et al. Preoperative assessment of meningioma stiffness using magnetic resonance elastography[J]. J Neurosurg, 2013, 118(3): 643−648. DOI: 10.3171/2012.9.JNS12519. [20] Elsheikh M, Arani A, Perry A, et al. MR Elastography Demonstrates Unique Regional Brain Stiffness Patterns in Dementias[J]. AJR Am J Roentgenol, 2017, 209(2): 403−408. DOI: 10.2214/AJR.16.17455. [21] Munder T, Pfeffer A, Schreyer S, et al. MR elastography detection of early viscoelastic response of the murine hippocampus to amyloid β accumulation and neuronal cell loss due to Alzheimer's disease[J]. J Magn Reson Imaging, 2018, 47(1): 105−114. DOI: 10.1002/jmri.25741. [22] Morisaka H, Motosugi U, Ichikawa S, et al. Magnetic resonance elastography is as accurate as liver biopsy for liver fibrosis staging[J]. J Magn Reson Imaging, 2018, 47(5): 1268−1275. DOI: 10.1002/jmri.25868. [23] Yin M, Glaser KJ, Talwalkar JA, et al. Hepatic MR Elastography: Clinical Performance in a Series of 1377 Consecutive Examinations[J]. Radiology, 2016, 278(1): 114−124. DOI: 10.1148/radiol.2015142141. [24] Masuzaki R, Tateishi R, Yoshida H, et al. Risk assessment of hepatocellular carcinoma in chronic hepatitis C patients by transient elastography[J]. J Clin Gastroenterol, 2008, 42(7): 839−843. DOI: 10.1097/MCG.0b013e318050074f. [25] Venkatesh SK, Yin M, Glockner JF, et al. MR elastography of liver tumors: preliminary results[J]. AJR Am J Roentgenol, 2008, 190(6): 1534−1540. DOI: 10.2214/AJR.07.3123. [26] Motosugi U, Ichikawa T, Koshiishi T, et al. Liver stiffness measured by magnetic resonance elastography as a risk factor for hepatocellular carcinoma: a preliminary case-control study[J]. Eur Radiol, 2013, 23(1): 156−162. DOI: 10.1007/s00330−012−2571−6. [27] 安訸, 石喻, 郭启勇. 3D磁共振弹性成像评估健康志愿者的胰腺弹性值的可行性研究[J]. 中国临床医学影像杂志, 2015, 26(9): 646−649.
An H, Shi Y, Guo QY. Feasibility of using 3D elastography to assess pancreatic stiffness in healthy volunteers[J]. J Chin Clin Med Imaging, 2015, 26(9): 646−649.[28] Shi Y, Gao F, Li Y, et al. Differentiation of benign and malignant solid pancreatic masses using magnetic resonance elastography with spin-echo echo planar imaging and three-dimensional inversion reconstruction: a prospective study[J]. Eur Radiol, 2018, 28(3): 1−10. DOI: 10.1007/s00330−017−5062−y. [29] Liu Y, Wang M, Ji R, et al. Differentiation of pancreatic ductal adenocarcinoma from inflammatory mass: added value of magnetic resonance elastography[J]. Clin Radiol, 2018, 73(10): 865−872. DOI: 10.1016/j.crad.2018.05.016.
计量
- 文章访问数: 15511
- HTML全文浏览量: 14362
- PDF下载量: 50