体素内不相干运动在甲状腺良恶性结节鉴别诊断中的价值

摘要

目的 探讨体素内不相干运动扩散加权成像(intravoxel incoherent motion diffusion-weighted imaging,IVIM-DWI)在甲状腺良恶性结节鉴别诊断中的价值.材料与方法 计划手术切除甲状腺结节患者32例、共44个结节(良性结节23个,恶性结节21个)纳入研究,术前均行常规MRI序列检查和IVIM-DWI序列扫描,手术病理确诊甲状腺结节性质.比较甲状腺良恶性结节组ADCstandard、ADCslow、ADCfast、f值,评估上述参数组间差异及诊断效能.结果 甲状腺恶性结节组ADCstandard、ADCslow、f值低于良性结节组,而ADCfast值高于良性结节组,ADCstandard、ADCslow值组间差异有统计学意义(P≤0.003).ADCfast值、f值组间差异无统计学意义(P值分别为0.888、0.226).ADCstandard值鉴别良性结节的受试者工作特征曲线(receiver operating characteristic,ROC)曲线下面积为0.759,其诊断敏感度、特异度分别为80.95%、60.87%.ADCslow值鉴别良性结节的ROC曲线下面积为0.808,其诊断敏感性、特异性分别为71.43%、86.96%.结论 IVIM-DWI序列中ADCstandard值、ADCslow值对鉴别甲状腺结节良恶性有较好的价值,其中ADCslow值ROC曲线下面积高于ADCstandard值ROC曲线下面积.%Objective: This study aimed to investigate the value of intravoxel incoherent motion (IVIM) diffusion weighted magnetic resonance for differentiation between the benign and malignant thyroid nodules. Materials and Methods: Thirty-two patients with forty-four thyroid nodules (benign nodules 23, malignant nodules 21) underwent conventional MRI sequences and IVIM sequence before operation. The ADCstandard (standard ADC), ADCslow (slow ADC), ADCfast (fast ADC) and f (fraction of fast ADC) values of benign and malignant thyroid nodules were compared. Diagnostic threshold and efficacy of these parameters for benign and malignant thyroid nodules were evaluated by receiver operating characteristic (ROC) curve. Results: The ADCstandard, ADCslow, f values of malignant thyroid nodule group were lower than those of benign nodule group, while ADCfast value was higher than that of the benign nodule group, and the ADCstandard and ADCslow values were statistically significant difference between the benign and malignant thyroid nodules (P≤0.003). The area under the curve of ADCslow was higher than ADCstandard , which was 0.808, and the sensitivity, specificitywere71.43%, 86.96% respectively; the area under the curve of ADCstandard was 0.759, the sensitivity, specificity were 80.95%, 60.87% respectively. ADCfast and f values were not statistically significant difference between the two groups. Conclusion: The ADCstandard and ADCslow values were valuable for differentiating benign and malignant thyroid nodules. The area under ROC curve of the ADCslow value is higher than that of the ADCstandard value.