3.0T磁共振体素内不相干运动扩散加权成像鉴别诊断脊柱不典型血管瘤与溶骨性转移瘤

目的 探讨3.0T MR体素内不相干运动（IVIM）成像对脊柱不典型血管瘤与溶骨性转移瘤的鉴别诊断价值。方法 回顾性收集18例脊柱不典型血管瘤患者（19个病灶）和25例脊柱转移瘤患者（69个病灶）。对所有患者均行3.0T MR扫描，包括常规序列和IVIM DWI序列，采用单指数模型后处理软件获得ADC值，采用双指数模型后处理软件获得IVIM参数，包括慢速扩散系数（ADC_slow值）、快速扩散系数（ADC_fast值）及快速扩散分数（f值）。采用独立样本t检验或Mann-Whitney U检验比较各参数值的差异。结果 脊柱不典型血管瘤和转移瘤的ADC值分别为（1.16±0.30）×10^-3 s/mm²、（0.80±0.27）×10^-3 s/mm²，差异有统计学意义（t=5.00，P<0.001）；ADC_slow中位数分别为0.78×10^-3 s/mm²、0.55×10^-3 s/mm²，差异有统计学意义（P=0.02）；ADC_fast分别为（63.06±33.89）×10^-3 s/mm²、（70.78±39.62）×10^-3 s/mm²，差异无统计学意义（t=0.77，P=0.44）；f分别为（40.65±14.75）%、（32.49±11.50）%，差异有统计学意义（t=2.57，P=0.01）。结论 IVIM可定量评估脊柱不典型血管瘤和溶骨性转移瘤的水分子扩散及微血管灌注特性，ADC、ADC_slow值对脊柱不典型血管瘤和溶骨性转移瘤具有一定的鉴别诊断价值。

Differential diagnosis of spinal osteolytic metastases from atypical hemangiomas using introvoxel incoherent motion at 3.0T MRI

Objective To investigate the diagnostic performance of introvoxel incoherent motion (IVIM) at 3.0T MR for distinguishing spinal metastases and atypical hemangiomas.Methods The retrospective study was performed of 18 patients with 19 spinal atypical hemangiomas and 25 patients with 69 spinal metastases. Conventional MR imaging and IVIM imaging were acquired at 3.0T MR scanner. The IVIM parameters including ADC value obtained by single exponential model, ADC_slow, ADC_fast, and fraction of ADC_fast (f) obtained by bio exponential model of spinal lesions were calculated by using the ADC analysis software. All IVIM parameters between spinal metastases and atypical hemangiomas were analyzed by using t test or Mann-Whitney U test.Results The ADC value of spinal metastases (×10^-3 s/mm²) was significantly lower than that of spinal atypical hemangiomas (×10^-3 s/mm²; t=5.00, P<0.001); the ADC_slow of spinal atypical hemangiomas and metastases were 0.78×10^-3 s/mm² and 0.55×10^-3s/mm² respectively (P=0.02); the ADC_fas were not significantly different between spinal metastases (×10^-3 s/mm²) and atypical hemangiomas (×10^-3 s/mm²; t=0.77, P=0.44); the f of spinal atypical hemangiomas was (40.65±14.75)% and that of metastases was (32.49±11.50)% (t=2.57, P=0.01).Conclusion IVIM imaging can quantitatively evaluate the characteristics of perfusion and diffusion in spinal metastases and atypical hemangiomas. ADC and ADC_slow are suitable for identification of atypical hemangiomas and osteolytic metastases.