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弥散加权成像与超声在甲状腺结节中的对比分析。

A comparative analysis of diffusion-weighted imaging and ultrasound in thyroid nodules.

机构信息

Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

BMC Med Imaging. 2019 Nov 21;19(1):92. doi: 10.1186/s12880-019-0381-x.

Abstract

BACKGROUND

Diffusion-weighted imaging (DWI) and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. We evaluated the utility of DWI and ultrasound in differentiating benign and malignant thyroid nodules.

METHODS

A total of 100 patients with 137 nodules who underwent both DWI and ultrasound before operation were enrolled. The T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The apparent diffusion coefficient (ADC) value and the SIR of benign and malignant thyroid nodules were analyzed by two-sample independent t tests. The sensitivity, specificity, and accuracy of DWI and ultrasound were compared with chi-square tests.

RESULTS

There was no significant difference in the SIR between benign and malignant thyroid nodules. The ADC value was significantly different. At the threshold value was 1.12 × 10 mm/s, the maximum area under the curve was 0.944. The sensitivity, specificity, and accuracy were 84.9, 92.2, and 87.6% respectively. The corresponding values of ultrasound diagnosis were 90.1, 80.4, and 86.9%.

CONCLUSIONS

Ultrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and the ADC value has high specificity, but there is no statistical difference in sensitivity or specificity between the two modalities. DWI and ultrasound each have their own advantages in differentiating benign and malignant thyroid nodules.

摘要

背景

弥散加权成像(DWI)和超声是常用于检查甲状腺结节的方法,但它们的比较价值很少被研究。我们评估了 DWI 和超声在鉴别甲状腺良恶性结节中的作用。

方法

共纳入 100 例术前同时行 DWI 和超声检查的 137 个结节患者。通过测量每个甲状腺结节的平均信号强度除以椎旁肌肉的信号强度来计算 T1 和 T2 信号强度比(SIR)。通过两独立样本 t 检验分析良性和恶性甲状腺结节的表观扩散系数(ADC)值和 SIR。采用卡方检验比较 DWI 和超声的灵敏度、特异度和准确性。

结果

良性和恶性甲状腺结节的 SIR 无显著差异。ADC 值有显著差异。在阈值为 1.12×10 mm/s 时,曲线下面积最大为 0.944。灵敏度、特异度和准确性分别为 84.9%、92.2%和 87.6%。超声诊断的相应值分别为 90.1%、80.4%和 86.9%。

结论

超声在鉴别甲状腺良恶性结节方面具有较高的灵敏度,ADC 值具有较高的特异度,但两种方法的灵敏度或特异度均无统计学差异。DWI 和超声在鉴别甲状腺良恶性结节方面各有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e790/6873449/c6ce46e08782/12880_2019_381_Fig1_HTML.jpg

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