Application of dynamic contrast enhanced MRI in the diagnosis of brucellar spondylitis

Objective To explore the value of Dynamic Contrast Enhanced(DCE) MRI in the clinical diagnosis, especially in the early stage of brucellar spondylitis. Methods Fifty six patients and ten healthy volunteers were included in this study. All the patients with brucellosis infections, ranged in age between thirty-five and sixty-two years old. This sample included thirty-two patients with brucellar spondylitis and twenty-four patients with strong back pain, however, the routine MRI showed no obvious abnormalities. The participants were scanned with routine MRI and DCE-MRI. The values of Ktrans,Kep,Ve, and Vp between the vertebral lesions of the patients suspected of brucellar spondylitis with no obvious abnormalities and the normal bodies in healthy volunteers were measured and compared. Under the Receiver Operating Characteristic(ROC) curve analysis, the sensitivity and specificity of the above four parameters were calculated. Results Quantitative parameters in this study have normal distribution and expressed as the mean (±standard deviation). The Ktrans, Kep, Ve and Vp values of the vertebral bodies in the pathological group were:(0.856 ± 0.539)ml/min, (1.482 ± 0.711)ml/min, (0.542 ± 0.267), and (0.034 ± 0.017), respectively. The normal vertebral bodies were (0.315 ± 0.298)ml/min, (0.713 ± 0.548)ml/min, (0.358 ± 0.259), and (0.056 ± 0.031), respectively. The differences between the two groups were statistically significant (P < 0.05). The values of Ktrans, Kep, Ve and Vp in the early lesion group were (0.666 ± 0.411) ml/min, (1.225 ± 0.824) ml/min, (0.429 ± 0.287) and (0.033 ± 0.025), respectively. Compared with the normal group, the values of Ktrans, Kep and Vp had significant difference (P < 0.5), and the values of Ve had no significant difference (P > 0.05); compared with the lesion group, the differences of Ktrans, Kep, Ve and Vp had no statistical significance (P > 0.05). The areas of Ktrans, Kep under the ROC curve were the largest. Conclusion The DCE-MRI quantitative analysis plays an important role in the early diagnosis of brucellar spondylitis. This technique should be further studied and widely applied.