The Value Of Intravoxel Incoherent Motion In The Differential Diagnosis Of Brucellosis Spondylitis,Tuberculous Spondylitis And Spinal Metastatic Tumors

Objective To quantitatively analyze brucellosis spondylitis,tuberculus spondylitis and spinal metastatic tumors by applying IVIM,and to evaluate the value of quantitative IVIM in the differential diagnosis of brucellosis spondylitis,tuberculus spondylitis and spinal metastatic tumors.And compare the coincidence rate with the routine MRI examination.Methods A paper collected 30 brucellar spondylitis patients with complete biochemical detection(SAT 1:100++or RBPT++),30 patients with tuberculus spondylitis,30 patients with spinal metastatic tumors,and diagnose 30cases of other spinal diseases(control group)at the same time.Analyze and compare the diagnostic coincidence rate of conventional MRI to three diseases with IVIM.All patients recieved routine and IVIM examinations,Slow ADC(D),Fast ADC(D*),and fraction of fast ADC(f)of diseased vertebral bodies of the patients with brucellosis spondylitis,tuberculus spondylitis and spinal metastatic tumors were mesured on maximal region.The results were compared among the three diseases and P<0.05was regared as statistically significant.Results The sensitivity and specificity of IVIM in diagnosing three diseases of brucellosis spondylitis,spinal tuberculosis and spinal metastases were 90%、80%;86%、83.3%;93.3%、86.7%respectively.The diagnostic accordance rates of conventional MRI for three diseases were 66.7%,73.3%and 70%,respectively.The diagnostic accordance rate of IVIM for three kinds of diseases was 90%,86%and 93.3%,which was higher than that of conventional MRI,and the difference was statistically significant(x~2=4.81,4.32,5.45,P<0.05).The area under AUC of D for brucellar spondylitis with spinal metastatic tumors is 0.881,corressponding diagnostic senstivity and specificity were 100%、87.5%;The area under AUC of D for brucellar spondylitis with tuberculus spondylitis were 0.825,corressponding diagnostic senstivity and specificity were 100%、88.9%。The area under AUC of f for brucellar spondylitis and spinal metastatic tumors was 0.778and corressponding diagnostic senstivity and specificity were 100%、87.5%。Conclusion The diagnostic coincidence rate of IVIM for three diseases was significantly higher than that of conventional MRI;In the IVIM quantitative analysis,the value of D and f have value in the differential diagnosis of brucellar spondylitis,tuberculus spondylitis and spinal metastatic tumors.