The value of dynamic contrast-enhanced MRI in the differentiation of brucellosis spondylitis, tuberculous spondylitis and spinal metastatic tumors

Objective: To quantitatively analyze brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors by dynamic contrast-enhanced (DCE)-MRI, and to evaluate the quantitative DCE-MRI in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors. Methods: This was a retrospective study including 30 patients with brucellar spondylitis, 30 with tuberculous spondylitis, and 30 with spinal metastatic tumors. The clinical and demographic data were collected. All patients received routine MRI and DCE-MRI examinations. Volume transfer constant(K^trans), rate constant(K_ep), extravascular extracellular volume fraction(V_e) and plasma volume fraction(V_p) of diseased vertebral bodies of the patients with brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors were measured on perfusion parameter maps. All indexes showed non-normal distribution. Differences of all indexes were compared and analyzed statistically with rank-sum test among the above diseases. Results: For brucellosis spondylitis, spinal tuberculosis, and vertebrae metastasis, the values of K^trans were (0.716 ± 0.017), (0.316 ± 0.004), (0.986 ± 0.012) min^-1, the values of K_ep were (1.326 ± 0.018), (0.747 ± 0.005), (2.899 ± 0.054) min^-1, the values of V_e were 0.541 ± 0.011, 0.427 ± 0.017, 0.338 ± 0.007 and the values of V_p were 0.034 ± 0.003, 0.029 ± 0.003, 0.049 ± 0.007. The differences suggested statistical significance(H = 50.24, 52.49, 48.31, 46.54, P < 0.01) among the three diseases. Conclusion: DCE-MRI quantitative analysis is helpful in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors. (authors)