Objective To explore the value of iterative decomposition of water and fat with echo asymmetry and the least squares estimation quantification sequence(IDEAL-IQ)and intravoxel incoherent motion(IVIM)in the differentia-tion of spinal metastases from myeloma.Methods A total of 45 patients with spinal metastases and 26 patients with mye-loma underwent IDEAL-IQ and IVIM scans to measure and compare the differences in FF,R2*,ADCstand,D,D*,f,DDC,and α values between the spinal metastases group and the myeloma group,respectively.Logistic regression(LR)analyses were used to find independent predictors,and area under the receiver operating characteristic(AUC)and DeLong tests were used to assess the diagnostic efficacy of each parameter and the differences between AUCs of different parame-ters,respectively.Results The FF,R2*,ADCstand,D,DDC and α values were lower in the myeloma group than in the metastatic tumor group,the D*values were higher than metastatic tumors(all P＜0.05),and there was no statistically sig-nificant difference in f-values between the two groups of patients(P=0.286).LR analysis showed that FF,R2*,D and αwere independent predictors for the differentiation of spinal metastases from myeloma,with an AUC of 0.976 for the combi-nation of all four,a sensitivity of 91.11％and a specificity of 92.31％.DeLong analyses showed that the differences be-tween AUC(FF+R2*+D+α)and AUC(FF),AUC(R2*),AUC(ADCstand),AUC(D),AUC(D*),AUC(DDC),AUC(α)were all statistically significant(Z=4.362,3.766,3.119,3.195,4.389,2.911,2.781,P＜0.001,＜0.001,0.002,0.001,＜0.001,0.003,0.005).Conclusion FF,R2*,D and α are independent predictors for the differ-entiation of spinal metastases from myeloma,and their combination enables a better differentiation of the above diseases than a single parameter.
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