Differential study of DCE-MRI parameters in spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis.

Objective: In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis were quantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to assess the value of DCE-MRI in the differential diagnosis of these diseases.

Methods: Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor (30 cases of each) received conventional MRI and DCE-MRI examination. The volume transfer constant (Ktrans ), rate constant (Kep ), extravascular extracellular volume fraction (Ve ) and plasma volume fraction (Vp ) of the diseased vertebral bodies were measured on the perfusion parameter map, and the differences in these parameters between the patients were compared.

Results: For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinal tuberculosis, respectively, the Ktrans values (median ± quartile pitch) were 0.989±0.014, 0.720±0.011 and 0.317±0.005 min-1 ; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1 ; the Ve values were 0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; the corresponding H values were 50.25 (for Ktrans ), 52.47 (for Kep ), 48.33 (for Ve ) and 46.56 (for Vp ), and all differences were statistically significant (two-sided P<0.05).

Conclusions: The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinal metastatic tumor, brucellar spondylitis and spinal tuberculosis.