DWI And CSI Used To Identiyf Vetrebral Osteoporosis And Metastatic Tumors Due To Compression Fractures Of The Value Study

Objective：MR diffusion weighted imaging (DWI) and chemical shift imaging(CSI) for the identification of osteoporosis and vertebral compression fractures causedby metastatic tumor diagnosis value.Materials and methods:1.Collected in June2012to April2012,56patients with vertebral compressionfractures, male29cases,27cases, age between45to75years old, average age58.5years. The34patients with fracture of osteoporosis compression (a total of48fracturevertebral body), no metastases lesions confirmed by surgery.Primary tumor (12cases),including lung cancer, breast cancer (5cases), kidney (1case), colon (1case), prostate(2cases) and unknown primary tumor (1case), the selected patients were not in front ofthe check for radiotherapy, chemotherapy and other invasive treatment.2.MR Scanning equipment, technology and image post-processing:2.1MR Scanning equipment, technology:GE Signa3.0T superconducting MRscanner compression fractures in34patients with osteoporosis (19females,15males,average age69years,) and22patients with vertebral metastatic compression fracturepatients (8females,14males, mean age63.4years). The scanning sequence includes:T1WI, T2WI, SE/EPIDWI (b value of300mm/s2,500mm/s2), CSI(In-phase,IP)and(Oppose-phase,OP).2.2Image post-processing:Collected data transmission to the diagnosticworkstation, combined with conventional MRI T1WI, T2WI sequence positioning ofthe vertebral body lesions. And image data transmission to ADW4.4workstation, theDWI data post-processing Functiontool software. CSI In-Phase and Oppose-phase signal strength were measured. Selected region of interest, the maximum display levelof the lesion and take the ADC value and the CSI signal intensity values,the region ofinterest (ROI) of approximately25-35mm2.The process of ROI, the ROI settings within there are strengthen the in the afterthe Enhanced of the lesions and (or) STIR sequence on the for its regional for HighSignal, provided to avoid the cystic degeneration, liquefied of of necrotic area, and asfar as possible to avoid the fracture line, in the fracture line circumference below as0.5cm department, select the the the signal is uniform, the a region of the stability of theimage quality, the the type of ADC and CSI were chosen the same region.Outcome measures:(1) osteoporosis and metastatic tumor compression fracture of the vertebral body inthe performance of the conventional MR sequences (T1WI, T2WI);(2) osteoporosis and metastatic tumor compression fractures of the vertebral bodyDWI performance; osteoporosis and metastasis neoplastic vertebral compressionfractures CSI performance;(3) osteoporosis ADC value and SIR value compression fractures of the vertebralbody compression fractures and metastases.4.Statistical Methods:Using the SPSS17.0software22metastases compression fractures and34osteoporosis compression fractures in patients with all the information for the followingstatistical analysis:(1) osteoporosis vertebral fractures and metastases vertebral fractures DWI and theperformance of the CSI signal type Wilcoxon test was used;(2) osteoporosis vertebral fractures and metastases vertebral fractures region ofinterest using a paired t-test;(3) osteoporosis vertebral fractures and metastases vertebral fractures of the ADCvalue and SIR values using ROC curve analysis, find the area under the curve (AUC)for the paired t-test was used to compare.Results: 1.Osteoporosis and vertebral compression fractures caused by metastatic tumorbetween DWI signal type and the CSI can there was no significant difference wereobserved in the signal type (p>0.05).2. B=300s/mm~2when osteoporosis vertebral compression fractures caused byADC values was (2.02±0.268)10-3mm/s2, vertebral compression fractures caused bymetastatic tumor of ADC value is (1.52±0.155)x10-3s/mm~2,p<0.05;b=500s/mm~2whenosteoporosis vertebral compression fractures caused by ADC values was(1.88±0.279)10-3s/mm~2,vertebral compression fractures caused by metastatic tumor ofADC value is (1.20±0.299)10-3s/mm~2,p<0.05.3.The ROC curve of the ADC value coverage SIR,SIR AUC value of0.866,SIR=0.845for the critical value, the sensitivity was84.5%,specificity was88.2%,,andaccuracy was62.8%;b=300s/mm~2,the ADC of the AUC value of0.925,as the boundaryvalue ADC1.685×103s/mm~2, the sensitivity was85.3%, specificity was89.6%,accuracy was63.1%;b=500s/mm~2,the ADC of the AUC value of0.960,as the boundaryvalue ADC1.44×103s/mm~2,the sensitivity was91.2%,specificity was91.7%,accuracywas76.8%.SIR and ADC AUC difference was statistically significant(P<0.05).Conclusion:1.DWI and CSI signal can not be to identify osteoporosis and metastatic tumorcompression fractures;2.In differentiating bone loose compression fractures and metastatic tumor compressionfractures aspects;MR b=500s/mm~2better than b=300s/mm~2diagnostic performance.3.To identify osteoporosis compression fractures and metastases compression fractureaspects.MR DWI is superior to CSI.