小视野DWI技术在甲状腺结节诊断中的应用评价  

Evaluation of reduced field-of-view diffusion imaging in thyroid nodules patients at 3T

作　　者：郝永红[1] 潘初[1] 陈唯唯[1] 肖云飞[1] 穆可涛[1] 朱文珍[1] 漆剑频[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《放射学实践》2016年第8期704-708,共5页Radiologic Practice

基　　金：湖北自然科学基金(2014CFB150;2014CFB292)

摘　　要：目的:定量和定性比较甲状腺小视野扩散加权成像(r-FOV DWI)和常规全视野扩散加权成像(f-FOV DWI)对甲状腺结节的诊断价值。方法:70例甲状腺结节患者在术前行甲状腺常规MRI序列及f-FOV和r-FOV DWI检查。由两位阅片者采用双盲法对两组DWI的图像质量和病变显示情况进行主观评分,测量甲状腺结节及正常组织的ADC值及图像变形率,并对比两种DWI序列定性、定量评估参数间的差异。结果:两位评阅者间主观评分的一致性良好(P均>0.05);r-FOV DWI的图像质量及病变显示情况的评分均显著高于常规f-FOV DWI(P<0.001),且图像变形率明显小于后者(P<0.001)。r-FOV DWI测得的甲状腺结节的ADC值低于f-FOV DWI(P<0.001),但两者在鉴别良恶性甲状腺结节的诊断效能相当(Z=0.253,P=0.802)。结论:甲状腺r-FOV DWI可以有效减少图像的变形、伪影及模糊度以获得较常规f-FOV DWI更高的图像质量和更佳的病变显示效果,为甲状腺微小病变的检出和诊断以及甲状腺DWI检查的标准化提供了更加有效的方法。Objective：To qualitatively and quantitatively evaluate the diagnostic performance of reduced field-of-view （r-FOV） DWI in a clinical population at 3T scanner with comparison of conventional full FOV （f-FOV） DWI. Methods： A total of seventy patients were finally included and underwent r-FOV DWI and f-FOV DWI of thyroid at 3T MR scanner. Image quality and lesion identification were evaluated both with a 4-point scale and geometric distortion rate were measured. The ADC value of thyroid nodules and normal thyroid tissues was calculated and compared. Results; The thyroid r-FOV DWI achieved significantly better image quality （P〈0. 001）, superior lesion identification effect （P〈0. 001） than f-FOV DWI with good agreement between readers. The r-FOV DWI achieved lower geometric distortion rate （P〈0. 001） than f- FOV DWI. Mean ADC values derived from r-FOV DWI were significantly lower than those of f-FOV DWI, while the area under the ROC for differentiating malignant and benign thyroid nodules based on mean ADC was comparable for both DWI methods. Conelusion..The r-FOV DWI is superior to conventional f-FOV DWI in providing better image quality,superior le- sion identification effect and comparable diagnostic performance,and can be a promising method for detecting and stratifying malignant lesions in the workup of thyroid nodules.

关 键 词：甲状腺结节 磁共振成像 扩散加权成像 表观扩散系数 小视野 

分 类 号：R445.2[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]