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European Spine Journal

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01-08-2015 | Original Article

Differentiation of tuberculosis and metastatic cancer in the spine using dynamic contrast-enhanced MRI

Authors: Ning Lang, Min-Ying Su, Hon J. Yu, Huishu Yuan

Published in: European Spine Journal | Issue 8/2015

Abstract

Purpose

To investigate the differences between imaging features of spinal tuberculosis (TB) and metastatic cancer measured by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). The presentation of TB on convention MRI may not show the typical TB signs, and they may be mis-diagnosed as malignant diseases. DCE-MRI may provide additional information to help making differential diagnosis.

Materials and methods

DCE-MRI was performed in 24 TB and 22 metastatic cancer patients. The DCE kinetic pattern was determined as “wash-out”, “plateau” or “persistent enhancement”. The characteristic DCE parameters were calculated from the signal intensity time course. The two-compartmental pharmacokinetic model was used to obtain K ^trans, which is the parameter associated with the delivery of MR contrast agents into the lesion, and k _ep, which is the parameter associated with the distribution and clearance of contrast agents from the lesion.

Results

Of the 24 TB, one case showed the wash-out kinetic pattern, 12 cases showed the plateau pattern, and 11 cases showed the persistent enhancement pattern. Of the 22 metastatic cancers, 12 cases showed wash-out, 7 cases showed plateau, and 3 cases showed persistent enhancement patterns. Compared to the metastatic cancer group, the TB group had a lower k _ep (0.27 ± 0.15 vs. 0.49 ± 0.23 min⁻¹, P < 0.001). The ROC analysis showed that the area under the curve was 0.780 for k _ep.

Conclusions

DCE-MRI may provide additional information for differentiation between spinal TB and metastasis, when their manifestations on conventional imaging were similar.

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Title: Differentiation of tuberculosis and metastatic cancer in the spine using dynamic contrast-enhanced MRI
Authors: Ning Lang
Min-Ying Su
Hon J. Yu
Huishu Yuan
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 8/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-3851-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Differentiation of tuberculosis and metastatic cancer in the spine using dynamic contrast-enhanced MRI

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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