MRI-DWI技术对脊柱结核、脊柱转移瘤的鉴别诊断及影像学分析

Differential Diagnosis Value and Imaging Characteristics of MRI-DWIin Spinal Tuberculosis and Spinal Metastases

目的分析磁共振扩散加权成像(MRI-DW)技术对脊柱结核、脊柱转移瘤的鉴别诊断价值及影像学特征。方法选取本院2017年4月至2019年6月收治且经手术病理确诊的54例脊柱结核、68例脊柱转移瘤患者作为研究对象。比较脊柱结核与脊柱转移瘤患者b值=500s/mm^(2)时正常椎体、骨髓水肿、椎体病变及椎旁病变组织的ADC值,并分析MRI-DWI鉴别诊断两者的敏感性、特异性。结果b值=500s/mm^(2)时,脊柱结核患者的正常椎体、骨髓水肿、椎体病变及椎旁病变组织的ADC值均高于脊柱转移瘤,其中两者正常椎体的ADC值比较无差异(P>0.05),骨髓水肿、椎体病变及椎旁病变组织的ADC值比较差异明显(P<0.05)。MRI-DWI检查鉴别诊断脊柱结核、脊柱转移瘤的敏感性、特异性分别为92.65%、92.59%。结论MRI-DWI具有良好的敏感性、特异性及准确性,可早期诊断与鉴别诊断脊柱结核与脊柱肿瘤,有效评估脊柱病变范围与程度,为临床诊治提供可靠的依据。

Objective To analyze the differential diagnosis value and imaging characteristics of magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)in spinal tuberculosis and spinal metastases.Methods 54 patients with spinal tuberculosis and 68 patients with spinal metastases diagnosed in our hospital from April 2017 to June 2019 were selected as the research subjects.The ADC values of normal vertebral body,bone marrow edema,vertebral body lesions,and paravertebral disease tissues at b value=500s/mm^(2) between patients with spinal tuberculosis and spinal metastasis were compared.The sensitivity and specificity of MRI-DWI in differential diagnosis of them were analyzed.Results When b value=500s/mm^(2),the ADC values of normal vertebral body,bone marrow edema,vertebral body lesions and paravertebral disease tissues of patients with spinal tuberculosis are higher than those of patients with spinal metastases(P>0.05).There was no difference in ADC value of normal vertebral body between them(P>0.05).The ADC values of bone marrow edema,vertebral body lesions and paravertebral disease tissues were significantly different(P<0.05).The sensitivity and specificity of MRIDWI in differential diagnosis of spinal tuberculosis and spinal metastases were 92.65%and 92.59%,respectively.Conclusion MRI-DWI has good sensitivity,specificity and accuracy.It can early diagnose and differentially diagnose spinal tuberculosis and spinal tumors,effectively evaluate the scope and extent of spinal disease,and provide a reliable basis for clinical diagnosis and treatment.