OBJECTIVE To explore the clinical value of magnetic resonance imaging (MRI) combined with serum soluble cluster of differentiation 14 subtype Presepsin and C-reactive protein (CRP) in the diagnosis of spinal tuberculosis infection.
METHODS A total of 109 patients with suspected spinal tuberculosis infection admitted to Xiaoshan District Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang Province from May 2019 to Dec. 2023 were selected as the research subject. Eighty patients of spinal tuberculosis and 29 patients of spinal metastases, diagnosed by pathological examination, were selected as tuberculosis group and metastatic tumor group, respectively. The general data, spinal lesions, MRI features, dynamic enhanced MRI scanning parameters and serum Presepsin and CRP levels were statistically analyzed, and the diagnostic values of dynamic enhanced MRI scanning parameters combined with serum Presepsin and CRP for spinal tuberculosis infection were analyzed.
RESULTS The percentages of patients with lesion morphology as long spindle shape, involving intervertebral disc, and lesion located in the anterior part of the vertebral body, paravertebral mass without enhancement, soft tissue lesions with uneven signal, and uneven T2-weighted images inside the vertebral body in the tuberculosis group were 88.75%, 81.25%, 56.25%, 43.75%, 77.50% and 83.75%, rsepectively, higher than those in the metastatic tumor group (P < 0.05). The volume transfer constant (Ktrans), rate constant (Kep) and plasma volume fraction (Vp) in the tuberculosis group were (0.46±0.21)1/min, (0.98±0.48)1/min, (0.04±0.02), respectirely, which were lower than those in the metastatic tumor group, while the volume fraction (Ve) of extravascular extracellular space and levels of serum Presepsin and CRP were (0.55±0.16), (367.62±154.38)pg/ml, (35.84±17.44)mg/L, respctpvely, which were higher than those in the metastatic tumor group (P < 0.05). The area under the curve (AUC) of dynamic contrast-enhanced MRI parameters Ktrans, Kep, Vp, Ve combined with serum Presepsin and CRP in the diagnosis of spinal tuberculosis was 0.875, which was higher than that of the single detection (P < 0.05).
CONCLUSIONS Compared with patients with spinal metastases, patients with spinal tuberculosis have spinal lesion features and MRI features, such as long spindle-shaped lesions, involvement of intervertebral discs and locations of the lesions in the anterior part of vertebral body, paravertebral masses without enhancement, uneven signals of the soft tissue lesions, and uneven T2-weighted images inside vertebral body, which can make changes in dynamic enhanced MRI scanning parameters and serum Presepsin and CRP levels. Dynamic enhanced MRI scanning parameters Ktrans, Kep, Vp and Ve combined with serum Presepsin and CRP can effectively improve the diagnostic value of spinal tuberculosis.
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