[1]陈张敏,商佳欢,魏鹏飞,等.体素内不相干运动技术在椎体良恶性压缩性骨折鉴别中的临床价值研究*[J].陕西医学杂志,2020,49(9):1085-1089,1093.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.008]
　CHEN Zhangmin,SHANG Jiahuan,WEI Pengfei,et al.Clinical value of IVIM technique in differential diagnosis of benign and malignant vertebral compression fracture[J].,2020,49(9):1085-1089,1093.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.008]
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体素内不相干运动技术在椎体良恶性压缩性骨折鉴别中的临床价值研究*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年9期
页码:
1085-1089,1093
栏目:
临床研究
出版日期:
2020-09-01

文章信息/Info

Title:
Clinical value of IVIM technique in differential diagnosis of benign and malignant vertebral compression fracture
作者:
陈张敏1; 2; 商佳欢2; 魏鹏飞2; 3; 杨 震3; 袁子逸2; 许荃颖2; 郑运松2; 3△; Djamaleil Aushev(哈萨克斯坦)2
1.长治医学院附属和平医院(长治 046000); 2.陕西中医药大学(咸阳 712046); 3.陕西中医药大学附属医院(咸阳 712000)
Author(s):
CHEN Zhangmin; SHANG Jiahuan; WEI Pengfei; et al.
Heping Hospital Affiliated to Changzhi Medical College(Changzhi 046000)
关键词:
磁共振成像;  扩散加权成像;  体素内不相干运动;  脊柱骨折;  压缩性骨折;  骨质疏松;  转移瘤
Keywords:
Magnetic resonance imaging;  Diffusion weighted imaging;  Intravoxel incoherent motion;  Spinal fractures;  Compression fractures;  Osteoporosis;  Metastatic tumor
分类号:
R445.2
DOI:
DOI:10.3969/j.issn.1000-7377.2020.09.008
文献标志码:
A
摘要:
目的:探讨体素内不相干运动(IVIM)鉴别诊断椎体良恶性压缩性骨折的临床价值。方法:收集胸腰椎椎体压缩性骨折患者80例,根据骨折原因将患者分为骨质疏松组和转移瘤组,其中骨质疏松组44例(70个椎体),转移瘤组36例(53个椎体)。两组均在常规MRI序列(T1WI、T2WI及STIR)上行IVIM扫描,观察椎体形态、椎体信号等的改变并通过MITK-Diffusion工作站测量得出IVIM各参数(ADC、D、D*及f),比较两组各参数的差异。应用ROC曲线分别评估常规MRI形态学、IVIM 参数以及二者联合的诊断效能。结果:两组T1WI、T2WI、STIR及IVIM序列信号比较,差异均无统计学意义(P>0.05)。常规MRI上,两组椎体形态、椎体后缘形态、椎弓根是否受累、有无椎旁软组织肿块比较均有统计学差异(均P<0.001),其中倒楔形的 ROC 曲线下面积(AUC)为0.825,敏感性及特异性分别为97.1%、67.9%。骨质疏松组ADC、D及D*值高于转移瘤组,差异均有统计学意义(均P<0.05)。两组间f值比较无统计学差异(P=0.059); ADC、D及 D*值在两组的 ROC 曲线下面积分别为0.871、0.889、0.625,截断值分别为1.33×10-3 mm2/s、1.18×10-3 mm2/s、13.11×10-3 mm2/s,敏感性分别为78.6%、88.6%、44.3%,特异性分别为84.9%、75.5%、83.0%。对常规MRI形态学、IVIM参数及常规MRI形态学联合IVIM 参数进行ROC曲线分析,结果表明常规MRI形态学联合IVIM 参数约登指数最大,为0.814。结论:在鉴别诊断椎体良恶性压缩性骨折上,常规MRI形态学中倒楔形的价值较高; IVIM技术较常规MRI形态学诊断效能更高,其中D值最有诊断价值; 常规 MRI 形态学联合IVIM技术诊断价值最高。
Abstract:
Objective:To explore the clinical value of intravoxel incoherent motion(IVIM)in differential diagnosis of benign and malignant vertebral compression fractures.Methods: 80 patients with thoracolumbar vertebral compression fractures were collected and divided into osteoporosis group(44 cases,70 vertebral bodies)and metastatic tumor group(36 cases,53 vertebral bodie)according to the cause of fracture.IVIM scanning was performed on the conventional MRI sequences(T1WI,T2WI and STIR)in both groups to observe the changes of vertebral body shape and vertebral body signal.The parameters of IVIM(ADC,D,D* and f)were measured by MITK-Diffusion workstation,and the differences between two groups were compared.ROC curves were used to evaluate the diagnostic efficacy of conventional MRI morphology,IVIM parameters and their combination.Results:There were no significant differences in T1WI,T2WI,STIR and IVIM signals between two groups(P>0.05).On conventional MRI,there were statistical differences between two groups(P<0.001)in the shape of vertebral body,the shape of posterior margin of vertebral body,the involvement of pedicle and the presence of paravertebral soft tissue mass,and the area under curve(AUC)of inverted wedge was 0.825,the sensitivity and specificity were 97.1% and 67.9%,respectively.The ADC,D and D* values of the osteoporosis group were higher than those of the metastatic tumor group,and the differences were statistically significant(P<0.05),but the difference in f value was not statistically significant between the two groups(P=0.059). The AUC of ADC,D and D* values of both groups were 0.871,0.889 and 0.625 respectively,and the cut-off values were 1.33×10-3 mm2/s,1.18×10-3 mm2/s and 13.11×10-3 mm2/s respectively,and the sensitivity were 78.6%,88.6% and 44.3% respectively,and the specificity were 84.9%,75.5% and 83.0% respectively.The ROC curve was used on conventional MRI morphology,IVIM parameters,and conventional MRI morphology combined with IVIM parameters,and showed that conventional MRI morphology combined with IVIM parameters has the largest Youden index,which was 0.814.Conclusion:In the differential diagnosis of benign and malignant vertebral compression fractures,the value of inverted wedge in conventional MRI morphology is higher.IVIM technology is more efficient than conventional MRI morphological diagnosis,of which D value is the most diagnostic value.Conventional MRI morphology in combination with IVIM technology has the highest diagnostic value.

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备注/Memo

备注/Memo:
*陕西省中医药管理局科研课题(2019-GJ-JC010);陕西省咸阳市重点研发计划项目(2019K02-111);陕西中医药大学校级科研课题研究生创新项目(2020CX04)
更新日期/Last Update: 2020-09-02