摘要
目的分析和总结MRDWI扫描试验在甲状腺良、恶性疾病中的表现特征。方法术前经MRI常规检查和DWI检查的甲状腺占位病变患者42例，男10例，女32例。年龄20-72岁，平均（42±13）岁，均经手术病理证实。利用美国GE公司图像后处理软件Functool，根据不同的b值（300、500、800s／mm^2）产生ADC值，比较良、恶性病变部位的ADC值，对其进行独立样本的t检验并绘制ROC曲线，分析试验的诊断效能。结果42例甲状腺占位病变样本中，病理诊断为良性的28例，包括甲状腺腺瘤20例、结节性甲状腺肿6例、桥本甲状腺炎2例；恶性肿瘤14例，包括甲状腺乳头状癌11例、滤泡样甲状腺癌2例、不典型增生1例。b值为300s／mm。时，甲状腺良性病变的ADC值为（2．39±0．38）×10^-3mm^2／s，恶性病变的ADC值为（1．60±0．56）×10^-3mm^2／s，差异有统计学意义（t=5．35，P〈0．05）。b值为500s／mm^2时，良性病变的ADC值为（1．85±0．33）×10^-3mm^2／s，恶性病变的ADC值为（1．65±0．42）×10^-3mm^2／s，差异没有统计学意义（t=1．70，P〉0．05）。b值为800s／mm^2时，良性病变的ADC值为（1．61±0．30）×10^-3mm^2／s，恶性病变的ADC值为（1．44±0．29）×10^-3mm^2／s，差异没有统计学意义（t=1．76，P〉0．05）。ROC曲线分析结果：b值为300s／mm^2时，以1．98×10^-3mm^2／s作为甲状腺良、恶性病变ADC值的临界值，灵敏度为85．7％，特异度为78．6％。结论b值为300s／mm^2时，DWI图像质量好，甲状腺良性病变的ADC值明显高于恶性病变的ADC值。
Objective To analyze and summarize the characteristics of thyroid diseases on the MR diffusion-weighted imaging. Methods Forty-two patients with thyroid lesions, including 10 males and 32 females [ age range 20-72 years, mean age （42 ± 13 ） years ] underwent MR DWI before surgery and biopsy. The diagnoses of thyroid lesions were confirmed by pathological results. ADC values of benign and malignant nodules, with different b values （b values was 300,500 and 800 s/mm^3） , were generated by using post-processing software Functool of GE company（USA）. The independent-samples t test was used and ROC curve was made to evaluate the diagnostic efficiency of the ADC values by using statistical software SPSS 12. 0. Results Histologically, there were 28 benign lesions and 14 malignant lesions. Benign lesions included 20 cases of thyroid adenoma, 6 cases of nodular goiter and 2 cases of Hashimoto＇s thyroiditis respectively. Malignant lesions consisted of 11 cases of thyroid papillary carcinoma, 2 cases of follicular thyroid cancer, and 1 case of dysplasia, mean ADC value of benign thyroid lesions was （2. 39 ± 0. 38） × 10^-3 mm^2/s and mean ADC value of malignant thyroid lesions was （1.60 ± 0. 56）×10^-3mm^2/s with b value of 300 s/mm^2. The statistical difference was significant between them （ t = 5.35, P 〈 0. 05 ）. The statistical difference of mean ADC values , between benign and malignant nodules with b value of 500 s/mm^2 [ （ 1.85 ±0.33） × 10^-3mm^2/s and （1.65 ±0.42） × 10^-3mm^2/s ], was insignificant （t = 1.70,P〉0.05）. Thestatistical difference of mean ADC values, between benign and malignant nodules with b value of 800 s/mm^2 [ （ 1.61± 0. 30） ×10 ^-3 mm^2/s and （ 1.44 ± 0. 29） ×10^-3 mm^2/s ], was insignificant （t = 1.76,P 〉 0. 05）. ROC curve indicated that the ADC value of 1.98 ×10^-3 mm^2/s or higher was the cut-off value for differentiating benign from malignant cold thyroid nodules, with a sensitivity of 85.7% , and a specificity of 78.6%. Conclusions The image quality is best with b value of 300 s/mm^2. Mean ADC value of benign lesions was significantly higher than mean ADC value of malignant lesions with b value of 300 s/mm^2.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2012年第6期500-504,共5页
Chinese Journal of Radiology
基金
上海市教委科研创新项目（12ZZ028）
上海市科委重点课题资助项目（09411950700）
关键词
甲状腺疾病
磁共振成像
弥散
Thyroid disease
Diffusion magnetic resonance imaging
