Maeda Takahide, Kato Hiroki, Ando Tomohiro, Kawaguchi Masaya, Shibata Hirofumi, Ogawa Takenori, Noda Yoshifumi, Hyodo Fuminori, Matsuo Masayuki
Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
Department of Otolaryngology, Gifu University, Gifu, Japan.
Jpn J Radiol. 2025 Feb;43(2):210-218. doi: 10.1007/s11604-024-01660-x. Epub 2024 Sep 18.
This study aimed to evaluate the MRI features of the main histological subtypes of thyroid cancer and enable differentiation between anaplastic thyroid carcinoma (ATC), poorly differentiated thyroid carcinoma (PDTC), and papillary thyroid carcinoma (PTC).
This study included 79 patients with histopathologically proven thyroid cancer (14 ATCs, 8 PDTCs, and 57 PTCs) who underwent neck MRI. MRI images were retrospectively reviewed and compared between the three pathologies.
The maximum diameter was larger in ATCs and PDTCs than in PTCs (65.2 mm and 38.4 mm vs. 26.0 mm, p < 0.01). The signal intensity ratio of the solid components on T2-weighted images (T2WIs) was higher in ATCs than in PTCs (1.13 vs. 0.89, p < 0.05). The predominant signal intensity of the solid components on T2WI exhibited hyperintensity relative to the spinal cord in ATCs more frequently than in PTCs (71% vs. 30%, p < 0.01), whereas hypointensity was more frequent in PTCs than in ATCs and PDTCs (60% vs. 0% and 13%, p < 0.01). Intratumoral ring-shaped hypointensity on T2WI was more frequent in ATCs than in PDTCs and PTCs (64% vs. 13% and 18%, p < 0.01). An ill-defined margin was more frequent in ATCs and PDTCs than in PTCs (93% and 63% vs. 25%, p < 0.01). Extrathyroidal extension, tracheal invasion, esophageal invasion, vascular invasion, and venous thrombosis were more frequently observed in ATCs than in PTCs (p < 0.05).
MRI could characterize the differences between ATCs, PDTCs, and PTCs.
本研究旨在评估甲状腺癌主要组织学亚型的MRI特征，并实现间变性甲状腺癌（ATC）、低分化甲状腺癌（PDTC）和乳头状甲状腺癌（PTC）之间的鉴别。
本研究纳入79例经组织病理学证实为甲状腺癌的患者（14例ATC、8例PDTC和57例PTC），均接受了颈部MRI检查。对MRI图像进行回顾性分析，并比较三种病理类型之间的差异。
ATC和PDTC的最大直径大于PTC（65.2mm和38.4mm对比26.0mm，p<0.01）。ATC在T2加权图像（T2WI）上实性成分的信号强度比高于PTC（1.13对比0.89，p<0.05）。与脊髓相比，ATC的T2WI上实性成分的主要信号强度呈高信号的频率高于PTC（71%对比30%，p<0.01），而PTC呈低信号的频率高于ATC和PDTC（60%对比0%和13%，p<0.01）。T2WI上肿瘤内环形低信号在ATC中比在PDTC和PTC中更常见（64%对比13%和18%，p<0.01）。边界不清在ATC和PDTC中比在PTC中更常见（93%和63%对比25%，p<0.01）。甲状腺外侵犯、气管侵犯、食管侵犯、血管侵犯和静脉血栓形成在ATC中比在PTC中更常见（p<0.05）。
MRI能够表征ATC、PDTC和PTC之间的差异。
