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Abstract：
Variations in the biomechanical stiffness of brain tumors can not only influence the difficulty of surgical resection but also impact postoperative outcomes. In a prospective, single-blinded study, we utilize pre-operative magnetic resonance elastography (MRE) to predict the stiffness of intracranial tumors intraoperatively and assess the impact of increased tumor stiffness on clinical outcomes following microsurgical resection of vestibular schwannomas (VS) and meningiomas. MRE measurements significantly correlated with intraoperative tumor stiffness and baseline hearing status of VS patients. Additionally, MRE stiffness was elevated in patients that underwent sub-total tumor resection compared to gross total resection and those with worse postoperative facial nerve function. Furthermore, we identify tumor microenvironment biomarkers of increased stiffness, including αSMA + myogenic fibroblasts, CD163 + macrophages, and HABP (hyaluronic acid binding protein). In a human VS cell line, a dose-dependent upregulation of HAS1-3, enzymes responsible for hyaluronan synthesis, was observed following stimulation with TNFα, a proinflammatory cytokine present in VS. Taken together, MRE is an accurate, non-invasive predictor of tumor stiffness in VS and meningiomas. VS with increased stiffness portends worse preoperative hearing and poorer postoperative outcomes. Moreover, inflammation-mediated hyaluronan deposition may lead to increased stiffness.
摘要：
脑肿瘤生物力学刚度的变化不仅会影响手术切除的难度，还会影响术后结局。在一个潜在的，单盲研究，我们利用术前磁共振弹性成像(MRE)预测颅内肿瘤术中僵硬度,并评估前庭神经鞘瘤(VS)和脑膜瘤显微手术切除后肿瘤僵硬度增加对临床结局的影响.MRE测量值与VS患者术中肿瘤硬度和基线听力状态显着相关。此外,与大体全切除术和术后面神经功能较差的患者相比，接受肿瘤次全切除术的患者的MRE僵硬度升高。此外，我们确定肿瘤微环境生物标志物增加的刚度，包括αSMA+肌源性成纤维细胞，CD163+巨噬细胞，和HABP(透明质酸结合蛋白)。在人类VS细胞系中，HAS1-3，负责透明质酸合成的酶的剂量依赖性上调，在用TNFα刺激后观察到，VS中存在的促炎细胞因子。一起来看,MRE是准确的，VS和脑膜瘤的肿瘤硬度的非侵入性预测。硬度增加的VS预示着术前听力较差，术后预后较差。此外，炎症介导的透明质酸沉积可能导致僵硬增加。
