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Use of monoexponential diffusion-weighted imaging and diffusion kurtosis imaging and dynamic contrast-enhanced-MRI for the differentiation of spinal tumors



To explore the diagnostic value of monoexponential diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), and dynamic contrast-enhanced (DCE)-MRI for differentiating between spinal malignant and non-malignant tumors lacking typical imaging signs and correlation between the parameters of the three models.


DWI, DKI, and DCE-MRI examinations were performed in 39 and 27 cases of spinal malignant and non-malignant tumors, respectively. Two radiologists independently evaluated apparent diffusion coefficient (ADC), mean diffusivity (MD), and mean kurtosis (MK) of the DWI and DKI models, and volume transfer constant (Ktrans), rate constant (kep), and extracellular extravascular volume ratio (ve) of the DCE-MRI model for post-processing analyses. Statistical differences of parameters were compared using an independent sample t test. The sensitivity, specificity, and the area under the receiver operating characteristic (ROC) curve were determined. Pearson correlation analysis was used to evaluate the correlation between these parameters.


ADC, MD, and ve were significantly lower, while MK and kep were significantly higher for spinal malignant tumors than for non-malignant tumors. The MK had the highest area under the ROC curve of 0.940 and sensitivity (96.3%). Ve was weakly positively correlated with ADC (r = 0.468) and MD (r = 0.363) and weakly negatively correlated with MK (r = −0.469). kep was weakly positively correlated with MK (r = 0.375). Ktrans was weakly positively correlated with ADC (r = 0.325).


Monoexponential DWI, DKI, and DCE-MRI have potential value in the differentiation of spinal malignant from non-malignant tumors lacking typical imaging signs, and there is a certain correlation between the parameters of the three models.

Graphic abstract

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Fig. 1
Fig. 2
Fig. 3
Fig. 4



Apparent diffusion coefficient


Area under curve


Dynamic contrast-enhanced-MRI


Diffusion kurtosis imaging


Diffusion-weighted imaging


Flip angle


Field of view


Intraclass correlation coefficient

K trans :

Volume transfer constant

k ep :

Rate constant


Mean diffusivity


Mean kurtosis


Receiver operating characteristic curve


Region of interest

v e :

Extracellular extravascular volume ratio


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This study has received funding by National Natural Science Foundation of China (81701648, 81971578) and Clinical key project of Peking University Third Hospital (BYSY2018007).

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Correspondence to Ning Lang.

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Zhang, J., Chen, Y., Zhang, E. et al. Use of monoexponential diffusion-weighted imaging and diffusion kurtosis imaging and dynamic contrast-enhanced-MRI for the differentiation of spinal tumors. Eur Spine J (2020).

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  • Diffusion magnetic resonance imaging
  • Spine
  • Area under curve
  • Sensitivity and specificity