动态对比增强MRI定量分析在布氏杆菌性脊柱炎、脊柱结核和脊柱转移瘤鉴别诊断中的价值
The value of dynamic contrast-enhanced MRI in the differentiation of brucellosis spondylitis,tuberculous spondylitis and spinal metastatic tumors
目的 应用动态对比增强(DCE)-MRI对布氏杆菌性脊柱炎、脊柱结核、脊柱转移瘤进行定量分析,评估定量DCE-MRI在上述疾病鉴别诊断中的价值.方法 搜集有完整生化检验或手术资料的布氏杆菌性脊柱炎、脊柱结核、脊柱转移瘤患者各30例.所有患者均行常规MRI及DCE-MRI检查,在灌注参数图上测量上述疾病患者病变椎体的容积转运常数(Ktrans)、速率常数(Kep)、血管外细胞外容积分数(Ve)、血浆容积分数(Vp)值.各指标均呈非正态分布,以中位数(M)±四分位数间距(Q)表示,3种病变各指标的比较采用秩和检验.结果 在布氏杆菌性脊柱炎、脊柱结核、脊柱转移瘤病变椎体中,Ktrans值分别为(0.716±0.017)、(0.316±0.004)、(0.986±0.012)min-1,Kep值分别为(1.326±0.018)、(0.747±0.005)、(2.899±0.054)min-1,Ve值分别为0.541±0.011、0.427±0.017、0.338±0.007,Vp值分别为0.034±0.003、0.029±0.003、0.049±0.007,3种病变间差异均有统计学意义(H值分别为50.24、52.49、48.31、46.54,P值均<0.01).结论 DCE-MRI定量分析在布氏杆菌性脊柱炎、脊柱结核、脊柱转移瘤鉴别诊断中具有一定价值.
更多Objective To quantitatively analyze brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors by dynamic contrast-enhanced (DCE)-MRI, and to evaluate the quantitative DCE-MRI in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors. Methods This was a retrospective study including 30 patients with brucellar spondylitis, 30 with tuberculous spondylitis, and 30 with spinal metastatic tumors. The clinical and demographic data were collected. All patients received routine MRI and DCE-MRI examinations. Volume transfer constant(Ktrans), rate constant(Kep), extravascular extracellular volume fraction(Ve) and plasma volume fraction(Vp) of diseased vertebral bodies of the patients with brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors were measured on perfusion parameter maps. All indexes showed non-normal distribution. Differences of all indexes were compared and analyzed statistically with rank-sum test among the above diseases. Results For brucellosis spondylitis, spinal tuberculosis, and vertebrae metastasis, the values of Ktrans were(0.716 ± 0.017),(0.316 ± 0.004),(0.986 ± 0.012)min-1, the values of Kep were(1.326 ± 0.018), (0.747 ± 0.005),(2.899 ± 0.054)min-1, the values of Ve were 0.541 ± 0.011, 0.427 ± 0.017, 0.338 ± 0.007 and the values of Vp were 0.034 ± 0.003, 0.029 ± 0.003, 0.049 ± 0.007. The differences suggested statistical significance(H=50.24, 52.49, 48.31, 46.54, P<0.01) among the three diseases. Conclusion DCE-MRI quantitative analysis is helpful in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors.
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