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扩散加权磁共振成像(DW-MRI)在甲状腺结节鉴别诊断中的有效性。

Effectiveness of diffusion-weighted magnetic resonance imaging (DW-MRI) in the differentiation of thyroid nodules.

作者信息

Özer Bilgen Mehpare, Pabuşçu Yüksel, Tarhan Serdar, Ovalı Gülgün Yılmaz, Aydede Hasan, Demireli Peyker, Karadeniz Tuğba

机构信息

Department of Radiology, Sincan Training and Research Hospital, Gökçek, 250. Cadde 2/A Sincan, Ankara, Turkey.

Faculty of Medicine, Department of Radiology, Celal Bayar University, Manisa, Turkey.

出版信息

Thyroid Res. 2024 Nov 18;17(1):24. doi: 10.1186/s13044-024-00210-x.

Abstract

BACKGROUND

The aim was to investigate which of two different b values (b 500 s/mm² and b 800 s/mm²) are more effective in the differentiation of benign-malignant nodules using Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI).

MATERIALS AND METHODS

Patients presenting with a preoperative diagnosis of nodular goiter or multinodular goiter were included in this study. These patients underwent neck MRI examinations, and their cases were analyzed retrospectively. A total of 26 patients were included in the study. A total of 46 nodules meeting the study criteria were examined. Measurements were performed on Apparent Diffusion Coefficient (ADC) maps of patients at two different b values (b 500 s/mm² and b 800 s/mm²), and the results were compared with histopathological findings.

RESULTS

Out of a total of 46 nodules, 37 were identified as benign, and 9 as malignant based on histopathological analysis. The mean ADC value at b 500 was lower in malignant nodules (1259.65 ± 328.13) compared to benign nodules (19037.48 ± 472.74). Similarly, the mean ADC value at b 800 was lower in malignant nodules (1081.72 ± 200.23) compared to benign nodules (1610.44 ± 418.06). When a cut-off value of 1.1 × 10 was accepted for the differentiation of pathology, the sensitivity for distinguishing pathology with ADC values at b 500 was 83.3%, with a specificity of 90.0%, and for ADC values at b 800, the sensitivity was 71.4%, with a specificity of 89.7%.

CONCLUSION

DW-MRI without the need for contrast agent administration is a useful method in the differentiation of benign-malignant thyroid nodules.

摘要

背景

目的是研究在使用扩散加权磁共振成像(DW-MRI)鉴别良恶性结节时,两个不同的b值(b 500 s/mm²和b 800 s/mm²)中哪一个更有效。

材料与方法

本研究纳入术前诊断为结节性甲状腺肿或多结节性甲状腺肿的患者。这些患者接受了颈部MRI检查,并对其病例进行回顾性分析。本研究共纳入26例患者。共检查了46个符合研究标准的结节。在两个不同的b值(b 500 s/mm²和b 800 s/mm²)下对患者的表观扩散系数(ADC)图进行测量,并将结果与组织病理学结果进行比较。

结果

在总共46个结节中,根据组织病理学分析,37个被鉴定为良性,9个为恶性。与良性结节(19037.48±472.74)相比,恶性结节在b 500时的平均ADC值较低(1259.65±328.13)。同样,与良性结节(1610.44±418.06)相比,恶性结节在b 800时的平均ADC值较低(—1081.72±200.23)。当接受1.1×10的临界值用于病理鉴别时,b 500时用ADC值区分病理的敏感性为83.3%,特异性为90.0%;对于b 800时的ADC值,敏感性为71.4%,特异性为89.7%。

结论

无需注射造影剂的DW-MRI是鉴别甲状腺良恶性结节的一种有用方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eb5/11571896/8c61b514085a/13044_2024_210_Fig1_HTML.jpg

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