Department of Radiology, Affiliated Hospital, Jiangnan University, No. 200, Huihe Road, Wuxi, Jiangsu 214062, China; Department of Radiology, Affiliated Renmin Hospital, Jiangsu University, No. 8, Dianli Road, Zhenjiang, Jiangsu 212002, China.
Department of Radiology, Affiliated Hospital, Jiangnan University, No. 200, Huihe Road, Wuxi, Jiangsu 214062, China; Department of Radiology, Affiliated Renmin Hospital, Jiangsu University, No. 8, Dianli Road, Zhenjiang, Jiangsu 212002, China.
Acad Radiol. 2021 Apr;28(4):467-474. doi: 10.1016/j.acra.2020.03.005. Epub 2020 Apr 14.
To evaluate whether quantitative diffusion-weighted MR imaging (DWI) with multi-b values can be used as a tool to predict the aggressiveness by using the histological feature of extrathyroidal extension (ETE) in papillary thyroid carcinoma (PTC).
238 patients were pathologically confirmed as PTCs underwent preoperative multi-b value DWI (300, 500, and 800 s/mm) between January 2015 and December 2017. The patients were divided into three groups according to the degree of ETE: without ETE, minimal ETE, and extensive ETE. The apparent diffusion coefficients (ADCs) were evaluated for three different b values (b = 300 s/mm, b = 500 s/mm, and b = 800 s/mm). The ADC values of the groups with and without ETE, minimal and extensive ETE were compared. The diagnostic relevance of the ADC values in terms of predicting ETE was compared using a receiver operating characteristic analysis. Differences between the areas under the curves (AUCs) were compared by using a Delong test.
PTCs with ETE had significantly lower ADC, ADC and ADC values than PTCs without ETE (p = 0.001, p < 0.001, and p < 0.001, respectively). The AUC of the mean ADC value (0.905) was higher than that of the ADC and ADC values (0.607 and 0.770, respectively) in differentiating ETE from without ETE (p < 0.001). The cut-off value of ADC to discriminate PTCs with and without ETE was determined at 1.407 × 10 mm/s, with sensitivity of 80.7%, specificity of 86.7%, and an AUC of 0.905.
The ADC value can be demonstrated an effective tool for evaluating the aggressiveness with the histological feature of ETE in PTC. In particular, ADC value at b = 500 s/mm showed the best performance for noninvasive preoperative evaluation of ETE.
评估多 b 值扩散加权磁共振成像（DWI）是否可作为一种工具，通过甲状腺外侵犯（ETE）的组织学特征来预测甲状腺乳头状癌（PTC）的侵袭性。
2015 年 1 月至 2017 年 12 月，对 238 例经病理证实为 PTC 的患者进行了术前多 b 值 DWI（300、500 和 800 s/mm）检查。根据 ETE 程度将患者分为无 ETE、微小 ETE 和广泛 ETE 三组。评估了三个不同 b 值（b=300 s/mm、b=500 s/mm 和 b=800 s/mm）的表观扩散系数（ADC）。比较了有和无 ETE、微小和广泛 ETE 组之间的 ADC 值。使用受试者工作特征分析比较 ADC 值预测 ETE 的诊断相关性。通过 Delong 检验比较曲线下面积（AUC）之间的差异。
有 ETE 的 PTC 的 ADC、ADC 和 ADC 值明显低于无 ETE 的 PTC（p=0.001、p<0.001 和 p<0.001）。平均 ADC 值（0.905）的 AUC 高于 ADC 值（0.607）和 ADC 值（0.770）在区分有和无 ETE 方面的 AUC（p<0.001）。用于区分有和无 ETE 的 ADC 值的截断值为 1.407×10mm/s，其灵敏度为 80.7%，特异性为 86.7%，AUC 为 0.905。
ADC 值可作为一种有效的工具，通过 ETE 的组织学特征评估 PTC 的侵袭性。特别是，b=500 s/mm 时的 ADC 值在 ETE 的非侵入性术前评估中表现最佳。
