Diffuse-weighted MR Imaging Diagnosis And Differential Diagnosis Of Spinal Metastases And Multiple Myeloma

ObjectiveTo evaluate the correlation between age and ADC values of different parts(vertebral and vertebral arch) of normal lumbar spine. Discuss the diagnostic and differential diagnostic value of MR diffusion weighted imaging(DWI) in spinal metastases and multiple myeloma. Methods89 healthy volunteers of different age were enrolled in study,using GE 1.5 T superconducting MRI scanner for the group were scan lumbar conventional MR imaging(T1WI、T2WI)and diffusion weighted imaging(DWI),conventional MR imaging including:scan sagittal FSE T2WI、T1WI and axial T1WI;Using the single spin echo diffusion weighted sequence obtain the lumbar sagittal diffusion weighted images, Proliferation-sensitive coefficient(b value)= 500s/mm2.The ADC values between different age groups in each part of lumbar spine were compare, analysis the difference of ADC between basivertebral and pedicle of vertebral arch.The partial correlation analysis was performed between each part of lumbar spine in different age groups.Selection of 59 patients with suspected spinal tumor, enrolled spinal routine MRI and DWI scan on the lesion site, 30 cases of patients with spinal metastases and 16 cases of multiple myeloma which were confirmed by surgery or clinical biopsy are included in the study.Analysis whether the signal changes of two kinds of spinal vertebral malignant tumor lesions in T1 WI, T2 WI and DWI have statistical significance.Measuring the lesions ADC values of spinal vertebral metastases group and multiple myeloma, analysis ADC values of the differences between two kinds of spinal spine tumor lesions and normal vertebral bodies, lesions of spinal vertebral metastases group and multiple myeloma with or without statistical significance. Results1.Lumbar vertebral arch ADC values between normal volunteers is higher than vertebral ADC values(P < 0.05);2.Vertebral and vertebral arch ADC value in youth group, middle-aged group, older group showing a downward trend as the growth of the age, among all age groups there was statistically significant difference.(F=5.126、3.012,P<0.05).Vertebral and vertebral arch ADC value was significantly negatively correlated with age(r=- 0.357、-0.374,P<0.05).3.Signal of lesion vertebra of spinal metastases group with multiple myeloma group in T1 WI, T2 WI and DWI sequence differences, the χ2test was not statistically significant(P>0.05).4.Average ADC values of spinal metastatic group, multiple myeloma group,and the general population groups is respectively:(1.054±0.155)×10-3mm2/s、(0.820±0.171)×10-3mm2/s and(0.316±0.113)×10-3mm2/s;spinal metastases vertebral ADC values is significantly higher than the general population groups, statistically significant differences between them(t= 21.642,P<0.01);spine multiple myeloma vertebrae group ADC values is significantly higher than the normal population group,the difference was statistically significant between the two(t=11.862,P<0.01);spinal metastatic group ADC values is significantly higher than the spine multiple myeloma group, statistically significant differences between them(t=4.933,P<0.01)。 Conclusions1.There are differences in normal adult vertebral ADC value and Lumbar vertebral arch ADC values,ADC value of the vertebral arch is relatively higher, so the different parts of the vertebral lesions should select the same part of the normal vertebral ADC value as a control reference.2. As the growth of the age, vertebral ADC values is on the decline. The research results show that age plays a significant role in ADC values of lumbar spine.3. The signal changes of spinal metastases and multiple myeloma in conventional MRI scan sequence T1 WI, T2 WI and DWI have no statistically significant difference, the conventional MRI and DWI signal doesn,t accurate to identify this two disease.4.Spinal metastases and multiple myeloma ADC values are higher than normal spinal ADC values, and spinal metastases ADC values are significantly higher than spinal myeloma,therefore, quantitative determination of ADC value of diffusion weighted imaging plays an important role in the diagnosis and differential diagnosis of spinal metastases and multiple myeloma.