颈部超声与磁共振弹性成像：生物力学基础、临床应用及方法学挑战
Ultrasound and Magnetic Resonance Elastography of the Neck: Biomechanical Basis, Clinical Applications and Methodological Challenges
AI总结：
本综述整合颈部组织生物力学基础、相关临床病症及超声与磁共振弹性成像的颈部应用，指出超声弹性成像对甲状腺结节等有诊断价值，颈部磁共振弹性成像尚处早期，提出测量报告建议并探讨多指标对疾病管理的作用。
摘要：
从慢性颈痛、头痛到甲状腺与淋巴结恶性肿瘤、放疗诱导纤维化，多种颈部疾病既源于颈部组织力学特性的改变，也会进一步改变这些特性，但临床评估仍依赖形态学检查、触诊及症状评估。超声弹性成像与磁共振弹性成像（MRE）现已可在体测量这些力学特性，不过颈部相关文献的方法学差异极大，且分散于不同模态与组织的研究中。本综述整合了颈部组织行为的生物力学基础、改变组织力学特性的临床病症，以及超声弹性成像与MRE在颈部的原理及应用。研究表明，超声弹性成像已展现出对甲状腺结节与宫颈淋巴结的诊断价值，而颈部MRE虽已证实可行性，但仍处于早期阶段。两种模态下，报告的测量值高度依赖纤维取向、体位、肌肉激活状态及采集条件。因此，本研究提出了报告建议，并探讨了除刚度外的测量指标（包括各向异性、黏性与非线性）如何改善疾病管理及为颈部计算模型提供信息。
英文摘要：
Many neck disorders, from chronic neck pain and headache to thyroid and nodal malignancy and radiation-induced fibrosis, both arise from and alter the mechanical properties of neck tissues, yet clinical assessment still relies on morphology, palpation and symptoms. Ultrasound and magnetic resonance elastography (MRE) now allow these properties to be measured in vivo, but the neck literature differs widely in methodology and remains dispersed across modalities and tissues. This review brings together the biomechanical basis of neck tissue behavior, the clinical conditions that alter it, and the principles and applications of ultrasound elastography and MRE in the neck. We show that ultrasound elastography has demonstrated diagnostic value for thyroid nodules and cervical lymph nodes, while neck MRE has been shown to be feasible but remains at an early stage. Across both modalities, reported values depend strongly on fiber orientation, posture, muscle activation and acquisition conditions. We therefore propose reporting recommendations and discuss how measurements beyond stiffness, including anisotropy, viscosity and nonlinearity, could improve disease management and inform computational models of the neck.
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