MRI unit, Radiology department. HT medica, Carmelo Torres 2, 23007 Jaén, Spain.
Radiology Department, Povisa Hospital, Vigo, Pontevedra, Spain.
Eur J Radiol. 2024 Jul;176:111499. doi: 10.1016/j.ejrad.2024.111499. Epub 2024 May 8.
Despite not being the first imaging modality for thyroid gland assessment, Magnetic Resonance Imaging (MRI), thanks to its optimal tissue contrast and spatial resolution, has provided some advancements in detecting and characterizing thyroid abnormalities. Recent research has been focused on improving MRI sequences and employing advanced techniques for a more comprehensive understanding of thyroid pathology. Although not yet standard practice, advanced MRI sequences have shown high accuracy in preliminary studies, correlating well with histopathological results. They particularly show promise in determining malignancy risk in thyroid lesions, which may reduce the need for invasive procedures like biopsies. In this line, functional MRI sequences like Diffusion Weighted Imaging (DWI), Dynamic Contrast-Enhanced MRI (DCE-MRI), and Arterial Spin Labeling (ASL) have demonstrated their potential usefulness in evaluating both diffuse thyroid conditions and focal lesions. Multicompartmental DWI models, such as Intravoxel Incoherent Motion (IVIM) and Diffusion Kurtosis Imaging (DKI), and novel methods like Amide Proton Transfer (APT) imaging or artificial intelligence (AI)-based analyses are being explored for their potential valuable insights into thyroid diseases. This manuscript reviews the critical physical principles and technical requirements for optimal functional MRI sequences of the thyroid and assesses the clinical utility of each technique. It also considers future prospects in the context of advanced MR thyroid imaging and analyzes the current role of advanced MRI sequences in routine practice.
尽管磁共振成像（MRI）并非甲状腺评估的首选成像方式，但由于其具有出色的组织对比度和空间分辨率，在检测和诊断甲状腺异常方面取得了一些进展。最近的研究集中在改进 MRI 序列和采用先进技术，以更全面地了解甲状腺病理学。尽管尚未成为标准实践，但高级 MRI 序列在初步研究中已显示出较高的准确性，与组织病理学结果相关性良好。它们在确定甲状腺病变的恶性风险方面显示出很大的潜力，这可能减少对活检等有创性程序的需求。在这方面，功能 MRI 序列，如弥散加权成像（DWI）、动态对比增强 MRI（DCE-MRI）和动脉自旋标记（ASL），已证明在评估弥漫性甲状腺疾病和局灶性病变方面具有潜在的应用价值。多房室 DWI 模型，如体素内不相干运动（IVIM）和弥散峰度成像（DKI），以及新兴方法，如酰胺质子转移（APT）成像或基于人工智能（AI）的分析，正在探索它们在甲状腺疾病中的潜在有价值的见解。本文综述了甲状腺功能 MRI 序列的关键物理原理和技术要求，并评估了每种技术的临床应用价值。还考虑了在高级 MR 甲状腺成像背景下的未来前景，并分析了高级 MRI 序列在常规实践中的当前作用。
