Diagnosis of Spinal Lesions Using Heuristic and Pharmacokinetic Parameters Measured by Dynamic Contrast-Enhanced MRI.
Diagnosis of Spinal Lesions Using Heuristic and Pharmacokinetic Parameters Measured by Dynamic Contrast-Enhanced MRI.
复制标题
DOI：
10.1016/j.acra.2016.12.014
复制
发表时间：
2017-07
影响因子：
4.8
通讯作者：
Su MY
中科院分区：
文献类型：
--
作者：
Lang N;Yuan H;Yu HJ;Su MY
本研究的目的是评价动态对比增强磁共振成像（DCE-MRI）的诊断性能，在区分四个脊柱病变的启发式和药代动力学参数分析，从DCE信号强度的时间进程。回顾性分析了62例确诊为脊柱骨髓瘤（n=9）、转移癌（n= 22）、淋巴瘤（n= 7）和炎性结核（TB）（n= 24）的受试者的DCE-MRI。将感兴趣区域放置在强烈增强的组织上。DCE时间进程被分类为“洗脱”、“平台”或“持续增强”模式。以造影剂注射后67秒的信号强度为参考，测量最大增强、最陡洗入增强和洗出斜率。应用Tofts二房室药代动力学模型获得Ktranss和kep。评估启发式参数与药代动力学参数之间的Pearson相关性，并进行受试者工作特征曲线分析以进行成对组区分。骨髓瘤的平均洗脱斜率为−22% ± 10%，转移癌为1% ± 0.4%，淋巴瘤为3% ± 3%，TB为7% ± 10%，可以显著区分骨髓瘤和转移瘤（曲线下面积[AUC] = 0.884）、淋巴瘤（AUC = 1.0）和TB（AUC = 1.0），P = 0.001，并区分转移与TB（AUC = 0.741），P = 0.005。kep和洗脱斜率高度相关（r = 0.92），它们显示出相似的诊断性能。Ktranss与最大增强（r = 0.71）和最陡的洗入增强（r = 0.85）显著相关，但与洗出斜率相比，它们的诊断性能较差。DCE-MRI可提供额外的诊断信息，简单的洗脱斜率具有最佳的诊断性能。启发式和药代动力学参数高度相关。
This study aimed to evaluate the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiation of four spinal lesions by using heuristic and pharmacokinetic parameters analyzed from DCE signal intensity time course. DCE-MRI of 62 subjects with confirmed myeloma (n=9), metastatic cancer (n= 22), lymphoma (n= 7), and inflammatory tuberculosis (TB) (n= 24) in the spine were analyzed retrospectively. The region of interest was placed on strongly enhanced tissues. The DCE time course was categorized as the “wash-out,” “plateau,” or “persistent enhancement” pattern. The maximum enhancement, steepest wash-in enhancement, and wash-out slope using the signal intensity at 67 seconds after contrast injection as reference were measured. The Tofts 2-compartmental pharmacokinetic model was applied to obtain Ktrans and kep. Pearson correlation between heuristic and pharmacokinetic parameters was evaluated, and receiver operating characteristic curve analysis was performed for pairwise group differentiation. The mean wash-out slope was −22% ± 10% for myeloma, 1% ± 0.4% for metastatic cancer, 3% ± 3% for lymphoma, and 7% ± 10% for TB, and it could significantly distinguish myeloma from metastasis (area under the curve [AUC] = 0.884), lymphoma (AUC = 1.0), and TB (AUC = 1.0) with P = .001, and distinguish metastasis from TB (AUC = 0.741) with P = .005. The kep and wash-out slope were highly correlated (r = 0.92), and they showed a similar diagnostic performance. The Ktrans was significantly correlated with the maximum enhancement (r = 0.71) and the steepest wash-in enhancement (r = 0.85), but they had inferior diagnostic performance compared to the wash-out slope. DCE-MRI may provide additional diagnostic information, and a simple wash-out slope had the best diagnostic performance. The heuristic and pharmacokinetic parameters were highly correlated.
登录
查看更多内容
影响因子：
3.8
作者：
Khalifa, Fahmi;Soliman, Ahmed;Dwyer, Amy C.
通讯作者：
Dwyer, Amy C.
影响因子：
6.4
作者：
Moehler, TM;Hawighorst, H;Goldschmidt, H
通讯作者：
Goldschmidt, H
影响因子：
50.5
作者：
Moulopoulos, LA;Maris, TG;Dimopoulos, MA
通讯作者：
Dimopoulos, MA
影响因子：
19.7
作者：
Rahmouni, A;Montazel, JL;Kobeiter, H
通讯作者：
Kobeiter, H
影响因子：
19.7
作者：
Chen, Bang-Bin;Hsu, Chao-Yu;Shih, Tiffany Ting-Fang
通讯作者：
Shih, Tiffany Ting-Fang