磁共振弹性成像及其在脑疾病中的应用

doi:10.11938/cjmr20233085

摘要/Abstract

摘要：

磁共振弹性成像（magnetic resonance elastography，MRE）是一种通过外界激励将剪切波动传递到所测量的软组织中，采用磁共振成像记录波动位移，并基于波动特征对软组织的力学参量进行估计的方法．脑组织的力学参量，尤其是粘弹参量与其生长、老化和疾病密切相关．本综述首先介绍MRE的理论原理以及软组织粘弹性的物理意义和表示方法，并以脑组织MRE为例说明MRE的技术方法及其扫描过程．其次，针对脑肿瘤和神经退行性疾病等典型的脑疾病，介绍MRE在临床研究中的应用，说明粘弹参量作为脑科学基础研究和疾病诊断的新生物标志物的意义．最后，对MRE在脑疾病和脑科学的应用相关研究热点开展了讨论．

关键词: 磁共振弹性成像, 脑肿瘤, 神经退行性疾病, 粘弹性, 生物标志物

Abstract:

Magnetic resonance elastography (MRE) is a method to estimate biomechanical properties of soft tissues by recording shear wave propagation using MR imaging. The wave excitation is produced by an external actuator and the properties are inversely calculated based on the wave equation. Biomechanical properties of brain tissue, especially the viscoelastic properties, are closely related to the growth, aging, and disease of brain. This review first introduces the theoretical background of MRE, followed by the physical meaning of the viscoelastic parameters and wave equations used for inversion. Scanning protocols for MRE, along with a specific example focusing on brain MRE, are also described. The paper presents various clinical applications of brain MRE, with a specific emphasis on brain tumors and neurodegenerative diseases. The application of viscoelastic properties as biomarkers in fundamental scientific research, disease diagnosis, and prognosis is discussed. We further highlight the current trends in brain MRE research covering both technical and clinical aspects, providing a reference for future neuroscience research and clinical applications.

Key words: magnetic resonance elastography (MRE), brain tumor, neurodegenerative disease, viscoelasticity, biomarker

中图分类号:

O482.53

冯原, 邱苏豪, 严福华, 杨广中. 磁共振弹性成像及其在脑疾病中的应用[J]. 波谱学杂志, 2024, 41(2): 209-223.

FENG Yuan, QIU Suhao, YAN Fuhua, YANG Guang-Zhong. Magnetic Resonance Elastography and Its Application in Brain Diseases[J]. Chinese Journal of Magnetic Resonance, 2024, 41(2): 209-223.

图/表 4

图1

图2

表1

MRE在脑肿瘤中的研究小结.所有研究均在3 T磁共振系统上开展

文献	肿瘤类型	患者总数（分布）	驱动器/序列	分辨率/mm³	反演算法	测量结果/kPa^*
[46]	脑膜瘤（4）、血管外皮细胞瘤（1）、神经鞘瘤（1）	6（2男/4女， 16~63岁）	电磁式驱动咬棒/GRE	1.875×1.875×5	-	肿瘤组织剪切模量幅值与手术直观判断相符
[47]	脑膜瘤（13）	13	气动枕/ SE-EPI	4×4×4	DI	肿瘤组织剪切模量幅值与手术直观判断相符
[48]	淋巴瘤（1）、胶质母细胞瘤（3）、间变性星形细瘤（3）、神经胶质瘤（4）、脑膜瘤（2）、脑转移瘤（3）	16（5男/11女， 26~78岁）	头部摇篮/ EPI	3×3×3	MDEV	\|G^*\| = 0.893~2.131
[49]	脑膜瘤（14）	14（4男/10女， 28~76岁）	气动枕/ SE-EPI	3×3×3	DI	肿瘤组织剪切模量幅值与手术直观判断相符
[50]	垂体大腺瘤（10）	10（5男/5女， 22~78岁）	气动枕/ SE-EPI	3×3×3	DI	软肿瘤平均剪切模量幅值 1.38±0.36 (1.08~1.86) 硬肿瘤平均剪切模量幅值 1.94±0.26 (1.72~2.32)
[51]	神经胶质瘤（18）	18（12男/6女，男性25~68岁，女性28~40）	气动枕/ SE-EPI	3×3×3	DI	平均剪切模量幅值 2.2±0.7 (1.1~3.8)
[52]	垂体腺瘤（38）	38（22男/16女， 22~78岁）	气动枕/ SE-EPI	3×3×3	DI	平均剪切模量幅值 1.8 (1.1~3.7)
[53]	脑膜瘤（13）、垂体腺瘤（11）、前庭神经鞘瘤（6）、胶质瘤（4）	34（11男/23女， 31~77岁）	气动枕/ SE-EPI	3.75 $×$ 3.75 $×$ 5	DI	平均剪切模量幅值脑膜瘤1.9±0.8，垂体腺瘤1.2±0.3，前庭神经鞘瘤2.0±0.4，胶质瘤1.5±0.2
[54]	脑膜瘤（18）	18（4男/14女， 62.8±15.3岁）	气动枕/ SE-EPI	1.875×1.875×3	DI	平均剪切模量幅值 3.12±1.23
[55]	脑膜瘤（88）	88（35男/53女， 22~77岁）	气动枕/ SE-EPI	3×3×3	DI	平均剪切模量幅值 3.81±1.74 (1.57~12.6)
[56]	胶质母细胞瘤（22）	22（12男/10女， 64.5±15.1岁）	头部摇篮/ SE-EPI	2×2×2	MEDV		\|G^*\| = 0.85~1.83 (1.32±0.26)
[57]	胶质母细胞瘤（11）、间变性星形细胞瘤（3）、脑膜瘤（7）、脑转移瘤（5）、脑内脓肿（1）	27（12男/15女， 49~75岁）	头部摇篮/ SE-EPI	2×2×2	MEDV		\|G^*\| = 1.43±0.33
[58]	转移瘤（1）、胶质母细胞瘤（3）、星形细胞瘤（1）、脑膜瘤（3）	8（3男/5女， 28~76岁）	头部摇篮/ SE-EPI	2×2×2	MEDV		脑膜瘤和星形细胞瘤 \|G^\| = 1.52±0.20；胶质瘤和转移瘤 \|G^\| = 1.28±0.14
[59]	胶质母细胞瘤（10）	10（5男/5女， 44~74岁）	机械转子/ GRE	3.1×3.1×3.1	NLI		G° = 1.15~1.62； G = 0.55~0.80

表1

表2

MRE在神经退行性疾病中的研究小结.所有研究均在3 T磁共振系统上开展

文献	疾病类型（患者数量）	患者年龄（岁）	驱动器/ 序列	分辨率/ mm³	反演算法	测量结果/kPa^*	所测量参量显著变化的区域
[63]	遗忘型轻度认知障碍（20）	23~81	气动枕/ 3D spiral	1.25×1.25×1.25	NLI	对照组：2.84±0.28 遗忘型轻度认知障碍： 2.63±0.32	阿蒙尼角1-2，齿状回-阿蒙尼角3
[64]	阿尔茨海默症（7）	76~94	气动枕/ SE-EPI	4×4×2.5	DI	CN-: 2.37 (2.17~2.62); CN+: 2.32 (2.18~2.67); AD: 2.20 (1.96~2.29)	全脑
[65]	阿尔茨海默症（8）	-	气动枕/ SE-EPI	3×3×3	DI	对照组：2.51±0.09 疾病组：2.40±0.09	额叶，颞叶以及一个复合区域（额叶、顶叶和颞叶，不包括中央前回和中央后回）
[66]	阿尔茨海默症（8）路易体痴呆（13）额颞叶痴呆（5）	78~88 55~79 54~65	气动枕/ SE-EPI	3×3×3	NLI	对照组：2.81±0.22 阿尔茨海默症：2.35±0.26 路易体痴呆：2.84±0.30 额颞叶痴呆：2.30±0.20	阿尔茨海默症：额叶、颞叶、扣带回、辅助运动区、楔前叶和眶前区路易体痴呆：楔前叶额颞叶痴呆：顶叶、额叶、颞叶、中央前叶、枕盖、岛叶、楔前叶、眶前叶、初级视觉区、扣带回和枕叶
[67]	阿尔茨海默症（21）	67~80	头部摇篮/ SE-EPI	1.9×1.9×1.9	MDEV	对照组：1.54±0.13 阿尔茨海默症：1.39±0.16	海马区
[68]	阿尔茨海默症（12）	70~87	气动枕/ 3D spiral	1.6×1.6×1.6	NLI	对照组：2.50±0.05 阿尔茨海默症：2.25±0.05	白质、皮质灰质（颞中上回和楔前叶）
[69]	帕金森症（17）进行性核上性麻痹（20）	49~78 62~82	头部摇篮/ SE-EPI	2×2×2	MDEV	对照组：1.04±0.08 帕金森症：0.96±0.065 进行性核上性麻痹： 0.95±0.078	帕金森症：额叶和中脑区域进行性核上性麻痹：额叶和中脑区域
[70]	肌萎缩侧索硬化症（14）	57±12	头部摇篮/ SE-EPI	2×2×2	TI	C₃₃: 27.63±2.05 (50 Hz), 40.39±3.68 (60 Hz); C₄₄: 4.21±0.06 (50 Hz), 4.68±0.07 (60 Hz); C₆₆: 4.89±0.09 (50 Hz), 5.35±0.13 (60 Hz)	皮质脊髓束
[71]	行为性额颞叶痴呆（5）	55~66	气动枕/ SE-EPI	3×3×3	DI	对照组：2.77（中位数）疾病组：2.57（中位数）	额叶和颞叶
[72]	阿尔茨海默症（8）路易体痴呆（5）额颞叶痴呆（5）常压脑积水（20）	78~87 63~76 54~65 60~86	气动枕/ SE-EPI	3×3×3	DI	对照组：2.44±0.08 阿尔茨海默症：2.32±0.09 路易体痴呆：2.43±0.11 额颞叶痴呆：2.28±0.10 常压脑积水：2.46 ±0.08	阿尔茨海默症：额叶、颞叶、顶叶和运动感知区路易体痴呆：无额颞叶痴呆：额叶和颞叶常压脑积水：顶叶、枕叶和运动感知区

表2

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