Purpose: To determine the diagnostic potential of Intravoxel Incoherent Motion (IVIM) MRI for differentiating malignant spinal tumours from acute vertebral compression fractures and tuberculous spondylitis, and to compare IVIM with diffusion-weighted imaging (DWI) and chemical shift imaging (CSI).
Methods: The Institutional Review Board approved this prospective study, and informed consent was obtained. IVIM MRI, DWI, and CSI at 1.5 T were performed in 25 patients with 12 acute compression fractures, 14 tuberculous spondylitis, and 18 malignant spinal tumours. The parameters of these techniques were assessed using the Kruskal-Wallis test. The diagnostic performance of the parameters was evaluated using receiver operating characteristic (ROC) analysis.
Results: ADC, SIR, Dslow, Dfast, and f values of malignant tumours were significantly different from those of acute compression fracture (for all, p < 0.05). The mean Dslow and Dfast values of malignant spinal tumours had significant differences compared with those of tuberculous spondylitis (for all, p < 0.05). However, no significant differences were observed in any quantitative parameters between the acute compression fracture and the tuberculous spondylitis (p > 0.05). Dslow•f showed the highest AUC value of 0.980 (95%CI: 0.942-1.000) in differentiating acute compression fracture and malignant spinal tumours. Dslow showed the highest AUC value of 0.877 (95%CI: 0.713-0.966) in differentiating tuberculous spondylitis and malignant spinal tumours.
Conclusions: IVIM MR imaging may be helpful for differentiating malignant spinal tumours from acute vertebral compression fractures and tuberculous spondylitis.
Keywords: Chemical shift imaging (CSI); Compression fracture; Diffusion magnetic resonance imaging; Diffusion-weighted imaging (DWI); Intravoxel incoherent motion (IVIM) MRI; Tuberculous spondylitis.
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