基于扩散磁共振成像的脑组织微结构成像在脑肿瘤诊疗中的应用  

The application of diffusion magnetic resonance imaging-based brain tissue microstructure imaging in the diagnosis and treatment of brain tumors

作　　者：胡芷瑄 毛椿平 王梦珠 严序 毛家骥[1] 沈君[1] HU Zhixuan;MAO Chunping;WANG Mengzhu;YAN Xu;MAO Jiaji;SHEN Jun(Department of Radiology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510120,China;MR Scientific Marketing,Siemens Medical Systems Co.,Ltd,Shanghai 201318,China)

机构地区：[1]中山大学孙逸仙纪念医院放射科,广州510120 [2]西门子医疗系统有限公司磁共振科研市场部,上海201318

出　　处：《磁共振成像》2024年第4期197-206,共10页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家重点研发计划项目(编号:2022YFA1104800)。

摘　　要：扩散MRI(diffusion MRI,dMRI)是一种利用水分子扩散速率和方向变化产生信号对比的成像技术,成像效果主要取决于MR信号采集及后处理中所采用的定量物理模型,对于在体无创揭示脑组织与脑部疾病的微结构信息方面具有重要的应用价值。近年来,dMRI领域中不断有新成像技术涌现,诸如基于新型扩散编码的多维度扩散成像(multidimensional diffusion,MDD)、平均表观传播MRI(mean apparent propagator MRI,MAP-MRI)以及基于多隔室模型的轴突定向扩散和密度成像(neurite orientation dispersion and density imaging,NODDI)等技术。本文从信号采集和模型拟合两个方面综述了基于dMRI的多种脑组织微结构成像技术目前的发展概况,以及其在脑胶质瘤和脑转移瘤等常见脑肿瘤中的初步应用,主要包括脑肿瘤的鉴别诊断、分级评估、分子分型、疗效评估和预后预测等临床关切的问题。未来,有待进一步优化基于dMRI的脑组织微结构成像技术的成像条件,比如设置合适的b值范围及成像时间,并进一步深入研究和比较各种新型脑组织微结构成像技术在上述关键临床问题中的应用价值,以期推动基于dMRI的脑组织微结构成像技术的发展与临床应用,从微观形态学角度全面揭示脑肿瘤的特征,为脑肿瘤的早期诊断、鉴别诊断、肿瘤分级、分子分型以及预后预测提供有力依据。Diffusion MRI(dMRI)is an imaging technique that utilizes signal contrast generated by the changes in degree and direction of water molecules during the diffusion process.The effectiveness of dMRI primarily relies on the acquisition of MR signals and the fitting models employed.dMRI has significant applications in non-invasively revealing the microstructural features of brain tissue and brain diseases.In recent years,innovative diffusion encoding models such as multidimensional diffusion(MDD),novel signal models such as mean apparent propagator MRI(MAP-MRI),and new compartment models such as neurite orientation dispersion and density imaging(NODDI),have been continuously proposed,which have greatly propelled the advancement of brain tissue microstructure imaging techniques.This article offers a comprehensive review of the current advancements in diverse brain tissue microstructure imaging technologies utilizing dMRI,focusing on signal acquisition and model fitting.It explores their initial use in prevalent brain tumors like gliomas and brain metastases,emphasizing clinical concerns such as distinguishing between different types of tumors,determining tumor grades,molecular subtyping,evaluating treatment effectiveness,and predicting patient prognosis.Moving forward,there is a need to enhance the imaging parameters of dMRI-based brain tissue microstructure imaging technologies by optimizing factors like b-value ranges and imaging duration.Moreover,further research and comparison are required to assess the utility of various innovative brain tissue microstructure imaging technologies in addressing the aforementioned critical clinical issues.The goal is to advance the development and clinical implementation of dMRI-based brain tissue microstructure imaging technologies,uncovering the unique features of brain tumors from a microscopic morphology perspective and providing substantial evidence for early diagnosis,differential diagnosis,tumor grading,molecular subtyping,and prognosis forecasting in brain tumor cases.

关 键 词：脑肿瘤 扩散磁共振成像 磁共振成像 扩散编码 信号模型 隔室模型 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]