Preliminary Study On Differential Diagnosis Of Vertebral Osteolytic Metastases And Hemangiomas By Magnetic Resonance IDEAL-IQ Sequence

Objective:This study explores the terative decomposition of water and fat with echo asymmetry and least-squares estimation quantification sequence(IDEAL-IQ)to accurately quantify fat content on vertebral body osteolysis.The feasibility and value of differential diagnosis between metastatic tumor and hemangioma.Methods:The first hospital affiliated to China Medical University was collected from August 2017 to August 2018.The clinically confirmed vertebral osteolytic metastases and hemangioma patients were 17 patients and 15 patients,respectively.All patients underwent GE 3.0T MRI routine.Sequence and IDEAL-IQ,IVIM-DWI sequence scan,the scanned data is transmitted to the AW4.6 workstation for post-processing,to generate a fat fraction map,and the best aspect of the lesion is displayed on the fat ratio map.The region of interest(ROI)measures the fat ratio and compares the fat ratio to the lesion fat ratio in the same part of the adjacent normal vertebral body.The measured data were in accordance with the normal distribution and expressed as mean ± standard deviation.The median distribution was not consistent with the normal distribution.The independent sample t-test and Mann-Whitney U test were used to analyze the statistical significance of fat content among groups..The standard ADC value and the slow ADC value were obtained by post-processing of intravoxel ihcoherent motion diffusion weighted imaging(IVIM-DWI),and the receiver operating characteristic curve(ROC)was used.Analyze and compare the diagnostic performance of magnetic resonance IDEAL-IQ fat ratio and IVIM-DWI parameters.Results:1.The fat content of the osteolytic metastasis group and the normal vertebral body were:(1.00-38.83)%,(32.83-74.28)%,and the fat content of the lesion was lower than that of the normal vertebral body fat.The difference between the two groups was statistically significant.Significance(P<0.05).2.The fat content of the hemangioma group and the normal vertebral body were:(58.39±12.95)%,(46.95±12.45)%,and the fat content of the lesion was higher than that of the normal vertebral body fat.The difference between the two groups was statistically significant(P<0.05).3.The fat content of the metastatic tumor group and the hemangioma group were(1.00-38.83)%,(58.39±12.95)%,and the fat content of the metastasis group(20/22)was mostly lower than that of the hemangioma group.The difference between the two groups was statistical.Academic significance(P<0.05).4.The area under the receiver-operating characteristic(ROC)of fat fraction and standard ADC value and slow ADC value were0.992,0.921,0.925,respectively.The sensitivity and specificity of fat fraction were100% and 90.9%,respectively.The diagnostic threshold is 27.79%.Conclusions:The osteolytic metastases have lower fat content than normal vertebrae,and the hemangioma has higher fat content than normal vertebrae.The IDEAL-IQ sequence can accurately quantify the difference in fat content between the lesion and the normal vertebral body,and fat fraction diagnostic efficiency is higher.The sensitivity and specificity are good.Therefore,the IDEAL-IQ sequence has a good diagnostic value for the differential diagnosis of vertebral osteolytic metastases and hemangioma.