MR多期增强在甲状腺良恶性结节中的诊断与鉴别诊断价值  

Diagnostic and differential diagnostic value of multi-phase contrast enhanced MR in benign and malignant thyroid nodules

作　　者：胡文娟 王浩 申晋疆 代泽东 宋彬 HU Wenjuan;WANG Hao;SHEN Jinjiang;DAI Zedong;SONG Bin(Department of Radiology,the Central Hospital of Minhang District,Shanghai 201199,China)

机构地区：[1]上海市闵行区中心医院放射科,上海201199

出　　处：《实用放射学杂志》2019年第10期1583-1586,1594,共5页Journal of Practical Radiology

基　　金：上海市卫生和计划生育委员会科研课题(201740242);上海市闵行区中心医院院级课题(2017MHLC06)。

摘　　要：目的探讨MR多期增强在甲状腺结节中的诊断与鉴别诊断价值。方法回顾性分析2015年9月至2018年1月经手术病理结果证实的176例(共257个病灶:恶性109个,良性148个)甲状腺结节患者的术前MR多期增强资料,分析评价MR多期增强在甲状腺结节鉴别诊断中的价值。结果流出环征是甲状腺乳头状癌比较特异性征象(χ2=125.03,P=0.000),诊断甲状腺乳头状癌的敏感性、特异性、阳性预测值、阴性预测值分别为66.06%、98.65%、97.30%、79.78%;明显强化在甲状腺良性结节中更常见(χ2=33.45,P=0.000),是腺瘤和腺瘤样结节比较特异性征象(χ2=74.75,P=0.000)。结论 MR多期增强在甲状腺结节的诊断与鉴别诊断中有非常重要的价值,流出环征是甲状腺乳头状癌特异性征象,明显强化有助于良性结节尤其是腺瘤及腺瘤样结节的诊断。Objective To investigate the value of multi-phase contrast enhanced MR in the diagnosis and differential diagnosis of thyroid nodules. Methods From September 2015 to January 2018,176 patients with 257 thyroid nodules(109 malignant and 148 benign)preoperatively evaluated by multi phase contrast enhanced MR were included in the present study.The final diagnoses for all cases were proved by the final pathological reports in our hospital.The diagnostic value of multi phase contrast enhanced MR in thyroid nodules was analyzed retrospectively. Results The outflow ling .sign can be regarded as a specific sign of papillary thyroid carcinoma (χ2=125.08,P=0.000) and the diagnostic sensitivity,specificity,positive predictive value anti negative predictive value were,98-65%,97,30% and 79,78%, respectively.Tlie obvious enhancement was more common in Itcnign thyroid nodules (χ2=33.45, P=0.000) and it can he regarded as a specific sign of adenoma and adenomatoid noduic(χ2=74.75,P=0.000).Conclusion The multi-phusc contrast enhanced MR has important clinical application value in the diagnosis and differential diagnosis of thyroid nodules. The outflow ring sign can be regarded as a specific sign of papillary thyroid carcinoma, and the obvious enhancement was an important feature of benign nodules,especially of adenoma and adenomatoid nodules.

关 键 词：甲状腺结节 磁共振成像 多期增强 

分 类 号：R581[医药卫生—内分泌] R445.2[医药卫生—内科学]