IVIM参数在脊柱转移瘤与脊柱结核鉴别诊断中的价值

目的 探讨3.0 T MR体素内不相干运动(IVIM)对于脊柱转移瘤与脊柱结核、脊柱转移瘤原发灶鉴别诊断的应用价值.方法 搜集经穿刺或手术病理证实为脊柱转移瘤(71例,其中肺癌43例,乳腺癌14例,肾癌14例)和脊柱结核(25例)患者的影像资料,用后处理软件测量感兴趣区(ROI)的标准表观扩散系数(ADCstand)、...

Values of IVIM Parameters in the Differential Diagnosis of Metastases and Tuberculosis in the Spine

Objective To investigate the value of 3.0 T MR intravoxel incoherent motion(IVIM) for the differential diagnosis of spinal metastases, spinal tuberculosis and primary lesions of spinal metastases. Methods The imaging data of 71 patients with spinal metastases(43 lung cancer, 14 breast cancer, 14 kidney cancer) and 25 patients with spinal tuberculosis were collected. Parameters of ADC_max,ADC_slow,ADC_fsxt,f, DDC and α from IVIM were measured. The independent samples t-test or ANOVA was used to compare the statistical difference. Substituted each parameter into Logistic regression model, identified meaningful parameters, and evaluated their joint diagnostic performance using ROC analysis. Results The ADC;values in the spinal metastases group were higher than those in the spinal tuberculosis group(P< 0.05),while the f values were lower(P< 0.05).ADC;and f were found to conform to the Logistic regression model, and the accuracy was 91.7%.In the ROC analysis, the AUC of ADC;and f were 0.903 and 0.859,respectively, and the AUC for the combined application of ADC;and f was 0.947.The ADC;,ADC;and DDC values of lung cancer were significantly lower than those of breast cancer and renal cancer(P< 0.05),and the α value of lung cancer was significantly higher than that of kidney cancer(P< 0.05). Conclusion IVIM parameters are helpful in differentiating spinal metastases from spinal tuberculosis, and have some application in differentiating different metastatic tumor types.