Logistic regression analysis of non-enhanced MR imaging,static and dynamic enhanced MR imaging in prediction of malignancy of vertebral compression fractures

ZHA Yun-fei; et al

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Logistic regression analysis of non-enhanced MR imaging,static and dynamic enhanced MR imaging in prediction of malignancy of vertebral compression fractures

更新时间：2024-01-17

- Logistic regression analysis of non-enhanced MR imaging,static and dynamic enhanced MR imaging in prediction of malignancy of vertebral compression fractures
- Journal of Chongqing Medical University Issue 10, Pages: 1208-1213(2008)
- 作者机构：
  
  1. 武汉大学人民医院放射科
  2. 中山大学附属第一医院放射科
- 作者简介：
- 基金信息：
- DOI：
  CLC： R580;R683;R445.2
- Published：2008，
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[1]查云飞,李茂进,杨建勇.非增强MRI、静态和动态对比增强MRI预测脊柱压缩性骨折良、恶性的Logistic回归分析[J].重庆医科大学学报,2008(10):1208-1213.

ZHA Yun-fei, et al. Logistic regression analysis of non-enhanced MR imaging,static and dynamic enhanced MR imaging in prediction of malignancy of vertebral compression fractures. [J]. Journal of Chongqing Medical University (10):1208-1213(2008)
[1]查云飞,李茂进,杨建勇.非增强MRI、静态和动态对比增强MRI预测脊柱压缩性骨折良、恶性的Logistic回归分析[J].重庆医科大学学报,2008(10):1208-1213. DOI：

ZHA Yun-fei, et al. Logistic regression analysis of non-enhanced MR imaging,static and dynamic enhanced MR imaging in prediction of malignancy of vertebral compression fractures. [J]. Journal of Chongqing Medical University (10):1208-1213(2008) DOI：

摘要

目的:评价非增强磁共振成像（Magnetic resonance imaging

MRI）、静态增强MRI和动态对比增强MRI对脊柱良、恶性压缩性骨折的鉴别诊断价值并确定不同检查方法中预测脊柱压缩性骨折良、恶性的最主要的MRI征象。方法:经临床和（或）病理组织证实的胸、腰椎体骨质疏松伴椎体急性压缩性骨折（Acute comtression fracture

ACF）43例（71个椎体）和胸、腰椎体恶性压缩性骨折（Malignant comtression fracture

MCF）49例（99个椎体）行非增强、钆剂T1WI静态和动态对比增强MR检查。以脊柱压缩性骨折的良、恶性作为因变量

各种MRI征象为自变量因素分别采用非增强MR（I模型1）、非增强MRI联合静态增强MRI（模型2）以及非增强MRI、静态增强MRI征象联合动态对比增强MR（I模型3）对脊柱压缩性骨折良、恶性的预测效果进行二值多元Logistic回归分析。不同的模型对脊柱压缩性骨折良、恶性预测的敏感性、特异性及准确性采用受试者操作特性曲线（Receiver operating characteristic

ROC）分析。结果:单因素分析结果显示:椎体T1WI信号均匀性、椎体后缘膨隆、椎体后上角后凸、椎弓根改变、硬膜外软组织肿块、椎旁软组织改变、椎体强化模式、椎旁软组织强化模式、椎体动态增强开始时间、时间信号强度曲线（Time-intensity curve

TIC）类型共10个征象在脊柱良、恶性压缩性骨折组间的差异有统计学意义（P值均<0.05）

椎体T2WI信号均匀性、椎体内液体征象、压缩椎体形态、椎间盘改变共4个征象在脊柱良、恶性压缩性骨折组间的差异无统计学意义（P值均>0.05）。ROC分析结果显示:非增强MRI、静态增强MRI联合动态对比增强MRI预测脊柱压缩性骨折良、恶性的效果优于非增强MRI或非增强MRI联合静态增强MRI

其诊断的敏感性、特异性和准确性分别为81.6%、90.7%和85.9%。Logistic回归分析结果显示:椎弓根改变、椎体强化模式以及TIC类型是预测脊柱压缩性骨折良、恶性的最主要的影响因素（OR值分别为3.558

4.666和0.007

P值均<0.05）。结论:非增强MRI、静态增强MRI联合动态对比增强MRI可以提高脊柱良、恶性压缩性骨折的鉴别诊断能力。

Abstract

Objective:To evaluate non-enhanced MR imaging

static and dynamic enhanced MR imaging in differentiation of be-nign from malignant vertebral compression fractures and to evaluate which MR imaging parameters are most predictive of malignancy.Methods:Non-enhanced MR imaging

static and dynamic gadolinium-enhanced MR imaging were performed on 43 patients with acute osteoporotic compression fracture and 49 patients with malignant compression fracture proved by clinical follow-up and/or histologic findings.Binary multivariate logistic regression analysis was used to identify the best combination of MR imaging parameters that might be predictive of malignancy.Subjective overall performance of diagnostic models for sensitivi-ty

specificity and accuracy was evaluated with receiver operating characteristic curve(ROC).Results:Univariate analysis showed that the frequency distribution of MR imaging parameters including T1 weighted imaging homogeneity of vertebrae

convex pos-terior of vertebrae

retropulsion of the posterosuperior angle of vertebrae

pedicle involvement

epidural soft tissue mass

paraverte-bral soft tissue lesions

pattern of enhancement of vertebrae

pattern of enhancement of paravertebral soft tissue lesions

start of dynamic enhancement and pattern of time-intensity curve(TIC) were different between benign and malignant compression frac-ture(P<0.05).However

T2 weighted imaging homogeneity of verte-brae

fluid sign

shape of vertebral collapse and intervertebral discinvolvement were not different between benign and malignant compression fracture(P>0.05).ROC analysis showed that combined non-enhanced

static and dynamic enhanced MR imaging parameters(model 3) were superior to non-enhanced MR imaging pa-rameter(smodel 1)iction of malignancy.The sensitivity

specificity and accuracy of model 3 were 81.6%

90.7% and 85.9%

respec-tively.Multivariate logistic regression analysis revealed the most discriminating parameters were pedicle involvement

pattern of enhancement of vertebrae and pattern of TIC(OR value were 3.558

4.666 and 0.007

respectively

P<0.05).Conclusion:Non-enhanced MR imaging combined with static and dynamic enhanced MR imaging can improve the differentiation between benign and ma-lignant vertebral compression fracture.

关键词

脊柱骨折回归分析磁共振对比增强

Keywords

spinefractureRegression analysismagnetic resonanceContrast enhancement

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