ADC值鉴别甲状腺结节的良恶性  

ADC values in differentiation of benign and malignant thyroid nodules

作　　者：闫斌[1] 刘红娟 王春宝 李敏[1] 闵志刚[1] 麻少辉[1] 范妤欣[1] 张明[1] 

机构地区：[1]西安交通大学医学院第一附属医院影像科 [2]ICU [3]病理科,陕西西安710061

出　　处：《中国医学影像技术》2011年第3期510-514,共5页Chinese Journal of Medical Imaging Technology

基　　金：西安交通大学医学院光华创新基金(0203127)

摘　　要：目的探讨MR DWI的ADC值鉴别诊断甲状腺良恶性结节的价值。方法回顾性分析27例（40个病灶）经病理证实的甲状腺结节患者资料,术前均接受常规MR、脂肪抑制增强扫描明确病变实性部分;单次激发自旋平面回波成像（SS SE-EPI）DWI扫描（b值取0、500 s/mm2）,测量实性部分的平均ADC值。依据病理结果将结节分为良性组及恶性组,比较其ADC值差异,绘制ROC曲线,确定诊断阈值,评价筛检效能。结果 40个结节中,甲状腺恶性结节15个,平均ADC值为（1.22±0.27）×10-3mm2/s,95%可信区间（1.07~1.37）×10-3mm2/s;良性结节25个,平均ADC值为（2.20±0.40）×10-3mm2/s,95%可信区间（2.04~2.37）×10-3mm2/s。恶性组平均ADC值显著低于良性组（P〈0.05）。ROC曲线下面积为0.98、诊断阈值1.49×10-3mm2/s时,诊断敏感度为86.70%,特异度为100%,准确率为95.00%。结论甲状腺良恶性结节的ADC值显著不同,MR DWI可鉴别甲状腺结节的良恶性。Objective To assess the application of ADC value in differentiating benign and malignant thyroid nodules with MR DWI.Methods The ADC values of 40 thyroid nodules from 27 patients confirmed pathologically were analyzed retrospectively.Routine MR T1W,T2W and contrast enhanced fat suppression scan were performed to confirm the solidity of thyroid nodules.DWI were acquired using single shot spin echo-planner imaging（SS SE-EPI） sequence with diffusion-sensitizing gradients using b factors of 0 and 500 s/mm2.Thyroid nodules were divided into malignant and benign groups based on the pathological findings.ADC values of both groups were compared and ROC curves were drawn to determine the diagnostic threshold and assess the screening test.Results Fifteen of 40 thyroid nodules were malignant and 25 were benign.The mean ADC value for benign thyroid nodules was（2.20±0.40）×10-3 mm2/s,95% confidence interval was（2.04—2.37）×10-3 mm2/s.The mean ADC value for thyroid malignancy was（1.22±0.27）×10-3 mm2/s,95% confidence interval was（1.07—1.37）×10-3 mm2/s,significantly lower than that of benign thyroid nodules（P0.05）.When the area under the ROC curve was 0.98,the diagnostic threshold was 1.49×10-3 mm2/s,the sensitivity,specificity and accuracy was 86.70%,100% and 95.00%,respectively.Conclusion ADC value of malignant thyroid nodules is of markedly different from that of benign ones.MR DWI helps to differentiation of benign and malignant thyroid nodules.

关 键 词：甲状腺结节 甲状腺疾病 扩散磁共振成像 

分 类 号：R736.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学]