多b值弥散加权成像对椎体良恶性压缩骨折鉴别诊断中的应用

目的探究多b值弥散加权成像(DWI)对椎体良恶性压缩骨折鉴别诊断中的应用。方法回顾性分析我院2014年8月至2017年8月我院收治的144例椎体压缩骨折患者的临床资料,其中外伤及骨质疏松所致良性椎体骨折患者89例,转移瘤所致椎体骨折患者55例。所有患者均行常规磁共振(MRI)序列(T1WI、T2WI)及b值为200、400、600、800s/mm2 DWI扫描。结果常规MRI信号及DWI信号类型比较差异均无统计学意义(P>0.05);当b值=200、400、600、800s/mm2时,良性椎体骨折表观弥散系数(ADC值)均显著高于恶性椎体骨折,差异具统计学意义(P<0.05);当b=600s/mm2时,ADC值诊断椎体良恶性骨折的灵敏度、特异度、准确度分别为87.14%、92.17%、80.22%,诊断效能最高。结论 MRI序列及DWI信号对椎体良恶性压缩骨折诊断效果不佳,可结合ADC值进行诊断,当b值为600s/mm2时,ADC值诊断椎体良恶性骨折的诊断效能最高。

Application of Diffusion Weighted Imaging with Multiple b Values in the Differential Diagnosis of Benign and Malignant Vertebral Compression Fractures

Objective To explore the application of diffusion weighted imaging(DWI) with multiple b values in the differential diagnosis of benign and malignant vertebral compression fractures. Methods The clinical data of 144 patients with vertebral compression fractures treated in the hospital from August 2014 to August 2017 were retrospectively analyzed. Among them, there were 89 patients with benign vertebral fractures caused by trauma and osteoporosis and 55 patients with vertebral fractures caused by metastatic tumors. All patients underwent conventional magnetic resonance imaging(MRI) sequences(T1 WI, T2 WI) and DWI with b values(200, 400, 600 and 800 s/mm2) scan. Results There was no significant difference in the conventional MRI signal and DWI signal types(P>0.05). When b values were 200, 400, 600 and 800 s/mm2, the apparent diffusion coefficient(ADC) valuesof benign vertebral fractures was significantly higher than those of malignant vertebral fractures(P<0.05). When b value was 600 s/mm2, the sensitivity, specificity and accuracy of ADC value in the diagnosis of benign and malignant vertebral fractures were 87.14%, 92.17% and 80.22% respectively, and the diagnostic efficiency was the highest. Conclusion The MRI sequence and DWI signal are not good for diagnosis of benign and malignant vertebral compression fractures. The ADC values can be used for diagnosis. When the b value is 600 s/mm2, the diagnostic efficiency of ADC value in the diagnosis of benign and malignant vertebral fractures is the highest.