Differentiating Acute Benign Vertebral Fractures from Vertebral Metastasis by Combining Quantification Analysis of Dual Echo Technique with Apparent Diffusion Coefficient
10.3969/j.issn.1002-1671.2009.12.027
- VernacularTitle:磁共振双回波技术与表观扩散系数的定量分析联合鉴别脊柱单纯性骨折与转移瘤
- Author:
Fan LIN
;
Yi LEI
;
Yangbin LI
;
Lilian TAN
;
Ke LIU
;
Zhiming LI
- Publication Type:Journal Article
- Keywords:
spine;
trauma;
metastasis;
apparent diffusioncoefficient;
MR imaging
- From:
Journal of Practical Radiology
2009;25(12):1785-1789,1813
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of dual echo technique in combination with apparent diffusion coefficient(ADC) in differentiating acute benign vertebral fracture from metastasis.Methods 43 patients (mean age, 68.2 years) with 79 metastatic vertebrae and 59 patients(mean age,60) with 68 acute vertebral fractures were included in our study.The slices of largest size of lesion on T1WI were selected to measure and calculate the signal intensity ratio(SIR) and ADC of lesions.The difference of ADC values and SIR between benign acute vertebral fractures and vertebral metastasis were compared.Parallel test,serial test and receiver operating characteristic curve(ROC) analysis of logistic model were done.Results ADC values of metastasis and acute benign fracture were (1.32±0.5)×10~（-3）mm~2/s and (2.39±0.4)×10~(-3)mm~~2/s respectively,and SIR of them were 1.00±0.01 and 0.85±0.01 respectively,there were significantly different between these two entities with the two tests(P<0.05).The area under the curve(AUC) for SIR was 0.897 and for ADC was 0.960,there is significantly different between these two tests in AUC(P=0.02).When 0.97 as cut off value for SIR,the sensitivity and specificity were 84.81% and 76.47%% respectively,when 1.87×10~(-3)mm~2/s as cutoff value for ADC , the sensitivity and specificity were 93.67% and 91.18% respectively . The sensitivity and specificity were 99.04% and 69.73% respectively in the parallel tests and 79.44%,97.92% in the serial test.A combining predictor established with logistic regression model showed a high AUC:0.985,which was higher than that of ADC and SIR alone.The AUC under ROC for ADC was significantly larger than that of SIR . When 0.55 as cut off value for this combining predictor , the sensitivity and specificity were 98.73% and 95.59% respectively.Multiple comparisons were performed with LSD-t test :combining predictor>ADC>SIR,it showed that there was significantly different between indexes(P<0.05). Conclusion ADC in combination with SIR can improve the effects in differentiating benign acute vertebral fractures and vertebral metastasis.
