| 樊秋菊,谭辉,于楠,杨祺,王少彧,贺太平,于勇,薛育.IVIM-DWI联合MRS鉴别诊断骨质疏松与转移性椎体压缩性骨折[J].中国医学影像技术,2018,34(2):297~301 |
| IVIM-DWI联合MRS鉴别诊断骨质疏松与转移性椎体压缩性骨折 |
| IVIM-DWI combined with MRS in differential diagnosis of osteoporotic fractures and metastatic vertebral compression fractures |
| 投稿时间：2017-06-26 修订日期：2017-11-21 |
| DOI：10.13929/j.1003-3289.201706138 |
| 中文关键词: 椎体 骨质疏松 脊柱骨折 肿瘤转移 扩散磁共振成像 磁共振波谱 |
| 英文关键词:Vertebra Osteoporosis Fractures Neoplasm metastasis Diffusion magnetic resonance imaging Magnetic resonance spectroscopy |
| 基金项目: |
| 作者 | 单位 | E-mail | | 樊秋菊 | 陕西中医药大学附属医院影像科, 陕西 咸阳 712000
陕西中医药大学基础医学与医学技术学院, 陕西 咸阳 712000 | | | 谭辉 | 陕西中医药大学附属医院影像科, 陕西 咸阳 712000
陕西中医药大学基础医学与医学技术学院, 陕西 咸阳 712000 | | | 于楠 | 陕西中医药大学附属医院影像科, 陕西 咸阳 712000
陕西中医药大学基础医学与医学技术学院, 陕西 咸阳 712000 | | | 杨祺 | 陕西中医药大学附属医院影像科, 陕西 咸阳 712000
陕西中医药大学基础医学与医学技术学院, 陕西 咸阳 712000 | | | 王少彧 | 西门子医疗系统有限公司磁共振事业部, 上海 200000 | | | 贺太平 | 陕西中医药大学附属医院影像科, 陕西 咸阳 712000
陕西中医药大学基础医学与医学技术学院, 陕西 咸阳 712000 | 782121989@qq.com | | 于勇 | 陕西中医药大学附属医院影像科, 陕西 咸阳 712000
陕西中医药大学基础医学与医学技术学院, 陕西 咸阳 712000 | | | 薛育 | 陕西中医药大学基础医学与医学技术学院, 陕西 咸阳 712000 | |
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| 中文摘要: |
| 目的 探讨体素内不相干运动DWI（IVIM-DWI）联合MRS鉴别骨质疏松与骨转移所致椎体压缩性骨折的价值。方法 收集因椎体压缩性骨折接受CT扫描并难以诊断的患者共70例，基于病理或临床随访结果将其分为骨质疏松组和转移组。对所有患者均行常规矢状位T1W、T2W、STIR序列和IVIM-DWI、1H-MRS扫描。测定4.7 ppm处水信号和1.3 ppm处脂质的相对峰下面积，评估IVIM-DWI参数和MRS参数，通过ROC曲线评估MRS、IVIM-DWI及两者联合对转移性椎体压缩性骨折的诊断效能，并计算曲线下面积（AUC）。结果 转移组的f值、D值和FF显著低于骨质疏松组，D*值明显高于骨质疏松组（P均<0.05）。MRS、IVIM-DWI及二者联合诊断骨质疏松和转移性椎体压缩骨折的敏感度、特异度、准确率分别为87.50%（28/32）、57.89（22/38）、71.43%（50/70），78.13%（25/32）、89.47%（34/38）、84.28%（59/70）及90.63%（29/32）、97.37（37/38）、94.29%（66/70）。MRS、IVIM-DWI及二者联合的AUC分别为0.73、0.88和0.94（P均<0.05）。结论 IVIM-DWI联合MRS可提高鉴别诊断骨质疏松与转移性椎体压缩性骨折的效能。 |
| 英文摘要: |
| Objective To explore the value of intravoxel incoherent motion DWI (IVIM-DWI) combined with single-voxel MRS in distinguishing osteoporotic fractures from metastatic vertebral compression fractures. Methods Totally 70 patients with vertebral compression fractures, who underwent CT scanner were enrolled. The patients were divided into osteoporotic group or metastatic group based on pathological results or clinical follow-up. All patients underwent conventional sagittal T1W, T2W, STIR, IVIM-DWI and single-voxel MRS scanning. Relative peak areas of the signal of water at 4.7 ppm and lipid at 1.3 ppm were determined. IVIM-DWI parameters (diffusion coefficient, pseudo diffusion, perfusion fraction) and MRS parameters (lipid water ratio, fat fraction) were also recorded. The diagnostic performance of MRS, IVIM-DWI, as well as MRS combined with IVIM-DWI in distinguishing osteoporotic fractures from metastatic vertebral compression fractures were evaluated by using ROC curve, and the area under curve (AUC) was calculated. Results The f, D and FF in metastatic group were significantly lower than those in osteoporotic group, while D* in metastatic group was significantly higher than that in osteoporotic group (all P<0.05). The sensitivity, specificity and accuracy in differentiating osteoporotic fractures from metastatic vertebral compression fractures was 87.50% (28/32), 57.89 (22/38) and 71.43% (50/70) of MRS, 78.13% (25/32), 89.47% (34/38) and 84.28% (59/70) of IVIM-DWI, 90.63% (29/32), 97.37% (37/38) and 94.29% (66/70) of MRS combining with IVIM-DWI, respectively. AUC of MRS, IVIM-DWI, as well as MRS combined with IVIM-DWI was 0.73, 0.88 and 0.94 (all P<0.05), respectively. Conclusion Combination of IVIM-DWI and MRS can improve the diagnostic efficiency of differentiating osteoporotic fractures from metastatic vertebral compression fractures. |
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