ABSTRACT
Objective To explore the value of dynamic contrast-enhanced (DCE).MRI in the early diagnosis of brucellosis spondylitis.Methods Fifty-six patients (24 female and 32 male) with Brucellosis with average age of (49± 3)years were retrospectively analyzed.Inclusion criteria:The patients with clinically diagnosed brinell coli spondylitis,drops of serum agglutination test degree 1:100＞(++),Hu＞red plate agglutination test (+ +),enzyme-linked immunosorbent assay to detect specific antibody IgG/IgM (+).Exclusion criteria:Pregnant and lactating women,patients with MRI examination contraindications and spinal tuberculosis,myeloma or other spinal disease,patients with the cervical,thoracic and lumbar 5 vertebral body involvement.The patients were classified into early lesion group and lesion group.Early lesion group was defined as low back pain less than a month,enzyme-linked immunosorbent assay positive IgM and negative IgG results,and no abnormality in conventional MR imaging,while lesion group was defined as low back pain for longer than 3 months,enzyme-linked immunosorbent assay positive IgG and negative IgM and marked lesion in conventional MR imaging.All the patients conducted with conventional MRI and DCE-MRI scan.The differences of the Ktrans,Kep,Ve and Vp between the vertebral lesions,early lesions of vertebral body and normal tissues were measured and compared.Results The values of Ktrans,Kep,Ve and Vp were significantly different between the vertebral lesions [(0.856±0.539) ml/min,(1.482±0.711) ml/min,0.542±0.267,0.034±0.017] and normal tissues [(0.315±0.298) ml/min,(0.713±0.548) ml/min,0.358±0.259,0.056±0.03](all P＜0.05).The values of Ktrans,Kep and Vp were significantly different between the early lesions of vertebral body and normal tissues (all P＜0.05),while no difference was found for Ve between the two groups (P＞0.05).Conclusion DCE-MRI quantitative analysis plays a role in the early diagnosis of the brucella spondylitis.
ABSTRACT
Objective To quantitatively analyze brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors by dynamic contrast-enhanced (DCE)-MRI, and to evaluate the quantitative DCE-MRI in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors. Methods This was a retrospective study including 30 patients with brucellar spondylitis, 30 with tuberculous spondylitis, and 30 with spinal metastatic tumors. The clinical and demographic data were collected. All patients received routine MRI and DCE-MRI examinations. Volume transfer constant(Ktrans), rate constant(Kep), extravascular extracellular volume fraction(Ve) and plasma volume fraction(Vp) of diseased vertebral bodies of the patients with brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors were measured on perfusion parameter maps. All indexes showed non-normal distribution. Differences of all indexes were compared and analyzed statistically with rank-sum test among the above diseases. Results For brucellosis spondylitis, spinal tuberculosis, and vertebrae metastasis, the values of Ktrans were(0.716 ± 0.017),(0.316 ± 0.004),(0.986 ± 0.012)min-1, the values of Kep were(1.326 ± 0.018), (0.747 ± 0.005),(2.899 ± 0.054)min-1, the values of Ve were 0.541 ± 0.011, 0.427 ± 0.017, 0.338 ± 0.007 and the values of Vp were 0.034 ± 0.003, 0.029 ± 0.003, 0.049 ± 0.007. The differences suggested statistical significance(H=50.24, 52.49, 48.31, 46.54, P<0.01) among the three diseases. Conclusion DCE-MRI quantitative analysis is helpful in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors.
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Objective To evaluate the predictive value of proton magnetic resonance spectroscopy (1H-MRS)and diffusion weighted imaging(DWI)in low-grade cerebral astrocytomas. Methods Twenty patients with histological proved low-grade astrocytomas treated with postoperative radiotherapy were evaluated with cMRIMRS, DWI before-and 3 months after radiotherapy respectively, then repeated every six months. rNAA,rCho,rCr,rADC was the ratio of NAA, Cho and Cr in the residual tumors region to the those of normal control region. The difference of rCho/rCr, rCho/rNAA, rADC between deteriorative group(group Ⅰ)and stable groups(group Ⅱ)were calculated both before-and 3months after radiotherapy. Results The value of rCho/rCr, rCho/rNAA were higher in group 1 than those in group Ⅱ 3 months after radiotherapy(t =3.65 and 4. 24,all P ＜ 0. 05), while the value of rADC was lower in group Ⅰ(t = 3.43, P ＜ 0. 05). The mean difference of rCho/rCr,rCho/rNAA, rADC in group Ⅰ were smaller than those in group Ⅱ(t = 2. 02,4. 21 and 3.00,all P ＜0. 05). The value of rCho/rCr,rCho/rNAA increased and rADC decreased gradually in group Ⅰ during follow up, and these patients were histologically proved recurrence within 11 - 16 months.While in group Ⅱ , the value of rCho/rCr, rCho/rNAA decreased and rADC increased gradually or steady.And also with a stable clinical performance and cMRI. Conclusions 1H-MRS and DWI own better predictive value of monitoring tumor metabolism change, growth potential and evaluation response to radiotherapy than conventional MRI in low-grade group astrocytomas.