动态增强磁共振成像联合磁共振弥散加权成像定量参数诊断脊髓病变的价值研究

doi:10.3969/j.issn.1006-6233.2025.08.026

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Abstract Objective:To analyze the value of quantitative parameters of dynamic enhanced magnetic resonance imaging (DCE-MRI) combined with diffusion-weighted imaging (DWI) in the diagnosis of myelopathy. Methods: A total of 75 patients with myelopathy admitted to our hospital from September 2020 to March 2022 were selected for routine MRI scan +DWI examination. DTI and DKI were added to the corresponding locations where abnormal signals were found, and DCE enhanced scanning was followingly performed. The pathology of spinal tumors was regarded as the gold standard. The DCE-M RI and DWI quantitative parameter indexes [DTI (FA, ADC value), DKI (MK value), IVIM-DWI (D, D* and f value), DCE (Ktrans, Kep, Ve value)] and microvascular density (MVD) of all groups were compared. The diagnostic value of DCE-MRI combined with DWI in myelopathy was analyzed. Results: Among the 75 patients with spinal cord lesions who were pathologically examined, 15 cases (20.00%) of spinal cord tumors and 60 cases (80.00%) of non-spinal cord tumors were confirmed, including 20 cases (26.67%) of cervical medullary degeneration due to disc herniation compression, 20 cases of MS 26.67%), and 20 cases (26.67%) of optic myelitis disease spectrum. Ktrans was higher in the spinal cord tumor group compared with the non-spinal cord tumor group, and ADC, FA value, and D levels were lower compared with the non-spinal cord tumor group (P<0.05). The MVD of spinal cord tumor group was (24.61±4.41) /mm², which was higher than that of non-spinal cord tumor group (19.57±4.06) /mm² (P<0.05). Pearson correlation analysis showed that MVD was negatively correlated with ADC, FA and D (r<0, P<0.05), and positively correlated with Ktrans (r>0, P>0.05);the results of plotting ROC curves showed that ADC, FA value, D, Ktrans, and combined detection all had AUC>0.70 for spinal cord tumors, which had predictive value, with the combined detection having the highest value; the diagnosis correct rate of DCE-MRI combined with DWI was 93.33% (70/75), and the agreement with pathological examination was k=0.911. Conclusion: DCE-MRI and DWI quantitative parameters can effectively diagnose and differentiate different types of spinal cord diseases, and are closely related to MVD, which is helpful to provide reference for the early identification and prevention of spinal cord diseases.

Key words： Spinal cord tumor Spinal cord lesion Dynamic enhanced magnetic resonance imaging Diffusion-weighted imaging Quantitative parameters

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.08.026 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I8/1376

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