Use Of Diffusion-Weighted Imaging And Apparent Diffusion Coefficient Of 1.5T Magnetic Resonance For The Differential Diagnosis Of Benign And Maligaant Vertebral Fractures.

Objective:The objective of our study is to explore the use of Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) of 1.5T MRI for the differential diagnosis of benign and malignant vertebral fractures.Materials and Methods:Conventional MRI sequences and DWI images of 79 patients with vertebral compression fractures and 28 normal volunteers from August 2009 to December 2010 were collected from our archives. The 94 patients included in the study sample did not take any form of medical treatment. The characteristics of diffusion-weighted imaging with different b values of benign and pathological body fractures were compared, and then the analysis of the difference in the apparent diffusion coefficient (ADC) values was carried out. We also tried to explore the value of using conventional MR sequences with DWI in the diagnosis of benign and malignant vertebral compression fracture. All the cases included in the study sample were confirmed histopathologically after surgery, or had undergone follow-up X-ray, CT, MRI or ECT imaging later. Image interpretation was performed independently by two experienced radiologists.Results:1.The diffusion-weighted magnetic imaging with different b values has different spatial resolution-the DWI images with b values of 400 s/mm2 are of high quality and stability and have the best spatial resolution and tissue contrast. So we chose the b value of 400s/mm2 to acquire the DWI images. The same region of interest measured by DWI images with different b values has different ADC values. 2.ADC values between different groups have statistically significant differences (P < 0.05).However, this statistical analyses was not considered significant in the differential diagnosis of benign and malignant vertebral lesions with the signal intensity (p=0.083,p> 0.05). 3.With increasing b value the ADC value gradually decreases, thus reducing the quality of the image. With the b value of 200s/mm2, there is no statistically significant differences between ADC values of different groups. With the b value of 400s/mm2, there was no significant difference in ADC values acquired from compression fractures caused by tumor and infectious diseases (p=0.093,p>0.05), but the ADC values between the other groups had significant differences statistically. 4.There were also statistically significant differences between DWI with the conventional MRI sequences and conventional MRI sequences in diagnosis of benign and malignant vertebral fractures (P=0.048, P<0.05).Conclusion:1.The combination of DWI and ADC values provide a new diagnostic approach and diagnostic criteria for the identification of benign and malignant vertebral compression fracture. DWI is a Magnetic Resonance Image (MRI) method that produces in vivo magnetic resonance images of biological tissues obtained from random movement of water molecules, and provides a reliable evidence for diagnosis. 2.Compared with using conventional magnetic resonance imaging sequence alone, it has higher accuracy while using DWI and conventional magnetic resonance imaging sequence together, which is of great significant value in clinical application.