Differential study of DCE-MRI parameters in spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis

OBJECTIVE: In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis were quantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to assess the value of DCE-MRI in the differential diagnosis of these diseases. METHODS: Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor (30 cases of each) received conventional MRI and DCE-MRI examination. The volume transfer constant (K(trans)), rate constant (K(ep)), extravascular extracellular volume fraction (V(e)) and plasma volume fraction (V(p)) of the diseased vertebral bodies were measured on the perfusion parameter map, and the differences in these parameters between the patients were compared. RESULTS: For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinal tuberculosis, respectively, the K(trans) values (median ± quartile pitch) were 0.989±0.014, 0.720±0.011 and 0.317±0.005 min(–1); the K(ep) values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min(–1); the V(e) values were 0.339±0.008, 0.542±0.013 and 0.428±0.018; the V(p) values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; the corresponding H values were 50.25 (for K(trans)), 52.47 (for K(ep)), 48.33 (for V(e)) and 46.56 (for V(p)), and all differences were statistically significant (two-sided P<0.05). CONCLUSIONS: The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinal metastatic tumor, brucellar spondylitis and spinal tuberculosis.