Intravoxel incoherent motion and dynamic contrast-enhanced MRI for assessing abnormalities of brucellosis spondylitis without conventional MRI changes
Objective To observe the value of intravoxel incoherent motion(IVIM)and dynamic contrast-enhanced MRI(DCE-MRI)for assessing abnormalities of brucellosis spondylitis(BS)without conventional MRI changes.Methods Data of 36 brucellosis patients with definite spinal lesions displayed on conventional MRI(BS1 group),14 cases without brucellosis infection nor abnormal spinal signals on MRI(control group)and 36 brucellosis patients without definite spinal lesions on conventional MRI(BS2 group)were retrospectively analyzed.The values of IVIM parameters,including perfusion fraction(f),pure water diffusion coefficient(D)and pseudo-diffusion coefficient(D*),also of DCE-MRI parameters,including time-intensity curve(TIC)type,volume transport constant(Ktrans),the rate constant(Kep)and volume fraction of extravascular extracellular space per unit tissue volume(Ve)were compared among groups.Univariate and multivariate logistic regression were used to screen independent factors for discriminating BS1 and BS2.Receiver operating characteristic curves were drawn,and the areas under the curve(AUC)were calculated to evaluate the efficiency of the above parameters for discriminating BS1 and BS2.Results Among IVIM parameters,compared with control group,D*values decreased but D values increased in BS1 group,while D*values increased in BS2 group(all adjusted P＜0.05).Compared with BS2 group,BS1 group had higher values of f and D and lower D*(all adjusted P＜0.05).In BS1 group,the TIC types were predominantly type Ⅰ(23/36,63.89％),which were wholly or predominantly type Ⅲ in BS2 group and control group,and of the former was significantly different with latter 2(both adjusted P＜0.05).Compared with control group,Ktrans increased progressively in both BS1 and BS2 groups(both adjusted P＜0.05).BS1 group had lower Kep and higher Ve than BS2 and control groups(all adjusted P＜0.05).Among univariate logistic regression models,the model including only f had lower capability for discriminating BS1 and BS2(AUC=0.759)than those including D,Ktrans and Ve(AUC=0.951,0.833,0.894,all P＜0.05).No significant different was found among multivariate logistic regression model including f and D,model including Ktrans and Ve nor model including all above parameters(all P＞0.05).Conclusion Both IVIM and DCE-MRI could be used to evaluate BS abnormality without conventional MRI changes.
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