| 王浩华,赵鹏飞,乔鹏飞.体素内不相干运动及动态对比增强MRI评估常规MRI无异常的布氏杆菌性脊柱炎病变[J].中国医学影像技术,2024,40(8):1226~1230 |
| 体素内不相干运动及动态对比增强MRI评估常规MRI无异常的布氏杆菌性脊柱炎病变 |
| Intravoxel incoherent motion and dynamic contrast-enhanced MRI for assessing abnormalities of brucellosis spondylitis without conventional MRI changes |
| 投稿时间：2024-01-06 修订日期：2024-05-09 |
| DOI：10.13929/j.issn.1003-3289.2024.08.025 |
| 中文关键词: 布鲁氏菌病 脊柱炎 早期诊断 磁共振成像 |
| 英文关键词:brucellosis spondylitis early diagnosis magnetic resonance imaging |
| 基金项目:内蒙古自治区自然科学基金(2023QN08044)、内蒙古自治区卫生健康科技计划(202202177)、内蒙古医科大学附属医院科研项目(2023NYFYPY007)。 |
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| 中文摘要: |
| 目的 观察体素内不相干运动(IVIM)与动态对比增强MRI (DCE-MRI)评估常规MRI无异常的布氏杆菌性脊柱炎(BS)病变的价值。方法 回顾性分析常规MRI显示明确脊柱病灶的36例布鲁氏菌病患者(BS1组)、14例未见脊柱异常信号的非布鲁氏菌病患者(对照组)和36例未见明确脊柱病灶的布鲁氏菌病患者(BS2组)。比较各组灌注分数(f)、单纯水分子弥散系数(D)及灌注相关伪弥散系数(D*)等IVIM参数,以及时间-信号强度曲线(TIC)类型、容积转运常数(Ktrans)、速率常数(Kep)及单位组织体积内血管外细胞外间隙容积分数(Ve)等DCE-MRI参数;以单因素及多因素logistic回归分析筛选鉴别BS1与BS2的独立因素,绘制受试者工作特征曲线,计算曲线下面积(AUC),评估其鉴别BS1与BS2的效能。结果 IVIM参数中,相比对照组,BS1组D*值降低、D值升高而BS2组D*值升高(校正P均＜0.05)。相比BS2组,BS1组f及D值较高而D*值较低(校正P均＜0.05)。BS1组TIC类型以Ⅰ型为主(23/36,63.89%),BS2组及对照组均为Ⅲ型或以Ⅲ型TIC为主,前者与后2组差异均有统计学意义(校正P均＜0.05)。相比对照组,BS1组、BS2组Ktrans依次升高(校正P均＜0.05);相比BS2组及对照组,BS1组Kep均较低而Ve均较高(校正P均＜0.05)。单参数模型中,仅纳入参数f值的模型鉴别BS1与BS2的效能(AUC=0.759)低于D、Ktrans及Ve(AUC=0.951、0.833、0.894,P均＜0.05);而纳入f和D值的联合参数模型、纳入Ktrans和Ve的联合参数模型及同时纳入IVIM及DCE-MRI的多参数模型的鉴别诊断效能差异均无统计学意义(P均＞0.05)。结论 IVIM及DCE-MRI均可用于评估常规MRI无法显示的BS病变。 |
| 英文摘要: |
| Objective To observe the value of intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced MRI (DCE-MRI) for assessing abnormalities of brucellosis spondylitis (BS) without conventional MRI changes. Methods Data of 36 brucellosis patients with definite spinal lesions displayed on conventional MRI (BS1 group), 14 cases without brucellosis infection nor abnormal spinal signals on MRI (control group) and 36 brucellosis patients without definite spinal lesions on conventional MRI (BS2 group) were retrospectively analyzed. The values of IVIM parameters, including perfusion fraction (f), pure water diffusion coefficient (D) and pseudo-diffusion coefficient (D*), also of DCE-MRI parameters, including time-intensity curve (TIC) type, volume transport constant (Ktrans), the rate constant (Kep) and volume fraction of extravascular extracellular space per unit tissue volume (Ve) were compared among groups. Univariate and multivariate logistic regression were used to screen independent factors for discriminating BS1 and BS2. Receiver operating characteristic curves were drawn, and the areas under the curve (AUC) were calculated to evaluate the efficiency of the above parameters for discriminating BS1 and BS2. Results Among IVIM parameters, compared with control group, D* values decreased but D values increased in BS1 group, while D* values increased in BS2 group (all adjusted P＜0.05). Compared with BS2 group, BS1 group had higher values of f and D and lower D* (all adjusted P＜0.05). In BS1 group, the TIC types were predominantly type Ⅰ (23/36, 63.89%), which were wholly or predominantly type Ⅲ in BS2 group and control group, and of the former was significantly different with latter 2 (both adjusted P＜0.05). Compared with control group, Ktrans increased progressively in both BS1 and BS2 groups (both adjusted P＜0.05). BS1 group had lower Kep and higher Ve than BS2 and control groups (all adjusted P＜0.05). Among univariate logistic regression models, the model including only f had lower capability for discriminating BS1 and BS2 (AUC=0.759) than those including D, Ktrans and Ve (AUC=0.951, 0.833, 0.894, all P＜0.05). No significant different was found among multivariate logistic regression model including f and D, model including Ktrans and Ve nor model including all above parameters (all P＞0.05). Conclusion Both IVIM and DCE-MRI could be used to evaluate BS abnormality without conventional MRI changes. |
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