| Purpose:To quantify the fat content of bone marrow in spinal hemangioma and common malignant tumor using MRI-Quantitative-Dixon sequence and to explore and prove its significance and value for the differential diagnosis of the two group.Materials and methods:A total of 36 cases of spinal malignancies confirmed by pathology,and 33 cases of spinal hemangiomas(2 cases of proved by pathology,and 31 cases confirmed by long-term follow-up for 6months without significant changes in lesion size and corresponding symptoms),were collected from January 2021 to January 2022 in the Affiliated Hospital of Qingdao University.All patients were performed routine sequence examination(T1WI,T2WI,FST2WI sequences)and q-Dixon sequence scan using Siemens 3.0T MRI(MAGNETOM Prisma,Siemens Healthcare,Munich,Germany).The scanned image were uploaded to workstation(Siemens Syngo.Via).The Fat Fraction(FF)diagram obtained automatically by q-Dixon examination was drawn to sketch the Region of interest(ROI)and the fat fraction value was obtained.The delineation criteria were:(1)lesions greater than 0.50cm~2.(2)The whole lesion was included to the maximum extent,but avoiding the bone cortex,vertebral endplate,vertebral basal vein,etc.(3)For multiple spinal tumors,each lesion with an area of more than 0.50cm~2 was measured and averaged.According to the delineation standard of ROI,ROI was delineated on the transverse fat fraction(FF)graph and FF values were measured respectively by two physicians specializing in imaging diagnosis.The average values of FF values measured by two physicians were taken as FF values of spinal hemangioma and common spinal malignancies.SPSS software was used to conduct statistical research on the data.Firstly,it was tested whether the two data met the normal distribution,and the measurement data that met the normal distribution was expressed as mean±standard deviation.Then,independent sample T test was used to analyze the statistical significance of fat content difference between the two data.Med Calc software was used to draw the Receiver operating characteristic curve(ROC),and calculate the critical value and analyze the diagnostic efficacy of FF value in differentiating spinal hemangioma and common spinal malignancies.Results:There were 36 common spinal malignancies,including 557 lesions(24 males,12 females,age range 46-82 years,mean age 61 years),including osteolytic metastases(15 cases,53 lesions),multiple myeloma(19 cases,456 lesions),and non-Hodgkin’s lymphoma(2 cases,48 lesions).Spinal malignancies involved vertebrae,including 155 cervical vertebrae,286thoracic vertebrae,113 lumbar vertebrae,and 3 sacral vertebrae.There were 33 cases of spinal hemangioma with 39 lesions(7 males,26females,age range 26-77 years,mean age 57 years),including 2 cases of invasive hemangioma with 2 lesions.Vertebrae involved by spinal hemangioma included 3 cervical vertebrae,32 thoracic vertebrae,4 lumbar vertebrae.SPSS24.0 software detected that the two groups of data met normal distribution.The FF value of common spinal malignancies was(12.85±10.65)%and that of spinal hemangioma was(62.18±17.23)%.FF values of common spinal malignancies were less than those of spinal hemangiomas,and the difference between the two groups was statistically significant(t=14.16,P=0<0.001),the ROC curve of FF value for differential diagnosis of spinal hemangioma and common spinal malignancies was drawn.The area under the curve(AUC)was 0.994,the sensitivity was100%and the specificity was93.94%.The critical FF value for distinguishing spinal hemangioma from common spinal malignancies was 39.85%.Conclusion:The present study proved the difference of fat content in spinal hemangioma and common spinal malignancies by Dixon sequence of MR.The fat content of spinal hemangioma is greater than that of common malignant tumors,and it can be used as one of the discriminating points.The critical FF value for distinguishing spinal hemangioma from common spinal malignancies was 39.85%. |
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