Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to JiaoTong University School of Medicine, Shanghai 200011, China.
Eur J Radiol. 2012 Nov;81(11):3313-8. doi: 10.1016/j.ejrad.2012.04.029. Epub 2012 May 17.
The exact place for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the diagnosis and management of thyroid tumors is still under debate. We performed the study to analyze and compare the parameters generated from DCE-MRI for thyroid lesions.
For each thyroid lesion, time intensity curves (TIC), time of peak enhancement (Tpeak), maximum enhancement ratio (ERmax) and maximum rise slope (Slopemax) were plotted and calculated. Receiver operator characteristics (ROC) analysis was conducted to assess the diagnostic ability and appropriate cut-off value. The area under the ROC curve (AUC) and the confidence intervals (CIs) were also assessed.
Forty-two patients were consecutively included. All 21 lesions demonstrated the rapid inflow and washout pattern (type-I) were benign. The 12 cases with delayed inflow pattern (type-III) were all malignant. When compared with the benign lesions, the thyroid carcinoma showed significantly lower Slopemax and higher Tpeak (P<0.05). No statistical difference of ERmax was found between malignant and benign ones (P=0.15). The AUC of ERmax, Slopemax and Tpeak in differentiating benign thyroid lesions from malignant ones were 0.63, 0.93 and 1, respectively. The ERmax cut-off value of 73.86 (sensitivity, 71.4%; specificity, 64.3%), Slopemax cut-off value of 2.4126 (sensitivity, 92.9%; specificity, 82.1%) and Tpeak value of 28 (sensitivity, 100%; specificity, 100%) offered the best diagnostic performances.
DCE-MRI, especially the pattern of TIC and the value of Slopemax and Tpeak, could be helpful in differentiating thyroid carcinoma from benign thyroid lesions.
动态对比增强磁共振成像（DCE-MRI）在甲状腺肿瘤的诊断和治疗中的具体作用仍存在争议。我们进行了这项研究，旨在分析和比较 DCE-MRI 生成的甲状腺病变参数。
为每个甲状腺病变绘制和计算时间强度曲线（TIC）、峰值增强时间（Tpeak）、最大增强比（ERmax）和最大上升斜率（Slopemax）。采用受试者工作特征（ROC）分析评估诊断能力和合适的截断值。还评估了 ROC 曲线下面积（AUC）和置信区间（CI）。
连续纳入 42 例患者。所有 21 个快速流入和洗脱模式（I 型）的病变均为良性。12 例延迟流入模式（III 型）的病变均为恶性。与良性病变相比，甲状腺癌的 Slopemax 明显较低，Tpeak 明显较高（P<0.05）。恶性与良性病变的 ERmax 无统计学差异（P=0.15）。ERmax、Slopemax 和 Tpeak 区分良性和恶性甲状腺病变的 AUC 分别为 0.63、0.93 和 1。ERmax 的截断值为 73.86（敏感性 71.4%，特异性 64.3%），Slopemax 的截断值为 2.4126（敏感性 92.9%，特异性 82.1%），Tpeak 值为 28（敏感性 100%，特异性 100%），具有最佳的诊断性能。
DCE-MRI，特别是 TIC 模式以及 Slopemax 和 Tpeak 的值，有助于区分甲状腺癌和良性甲状腺病变。
