中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
47期
3351-3354
,共4页
弥散加权成像%甲状腺结节%ADC值
瀰散加權成像%甲狀腺結節%ADC值
미산가권성상%갑상선결절%ADC치
Diffusion weighted imaging%Nodular thyroid lesions%Apparent diffusion coefficient value
目的 探讨磁共振弥散加权成像对甲状腺良恶性结节的鉴别诊断价值.方法 搜集2004年11月至2006年2月在天津医科大学总医院及肿瘤医院就诊的甲状腺结节病变患者.采用平面回波成像技术对60例甲状腺结节病变(良恶性各30例)行DWI检查,分别测量b值取0和100、200、300、400 s/mm2时病变的ADC值,比较其间差异.所有病变均经手术病理证实.结果 当选取不同的b值时,所测得的良、恶性结节的ADC值之间均在统计学差异,且恶性结节组的ADC值小于良性结节组的ADC值(P＜0.05).根据兼顾DWI图像的信噪比和能够准确测量ADC值的原则,在多种b值的DWI检查中,宜选择400 s/mm2作为检查甲状腺结节性病变的最佳b值.当b值选择400 s/mm2时,绘制ROC曲线,并选取ADC值1.475×10-3 mm2/s作为阈值,诊断甲状腺恶性结节的敏感性、特异性分别为93.3%、96.7%.结论 甲状腺恶性病变的ADC值低于良性病变.DWI和ADC值在甲状腺结节病变的鉴别诊断中具有重要价值.
目的 探討磁共振瀰散加權成像對甲狀腺良噁性結節的鑒彆診斷價值.方法 搜集2004年11月至2006年2月在天津醫科大學總醫院及腫瘤醫院就診的甲狀腺結節病變患者.採用平麵迴波成像技術對60例甲狀腺結節病變(良噁性各30例)行DWI檢查,分彆測量b值取0和100、200、300、400 s/mm2時病變的ADC值,比較其間差異.所有病變均經手術病理證實.結果 噹選取不同的b值時,所測得的良、噁性結節的ADC值之間均在統計學差異,且噁性結節組的ADC值小于良性結節組的ADC值(P＜0.05).根據兼顧DWI圖像的信譟比和能夠準確測量ADC值的原則,在多種b值的DWI檢查中,宜選擇400 s/mm2作為檢查甲狀腺結節性病變的最佳b值.噹b值選擇400 s/mm2時,繪製ROC麯線,併選取ADC值1.475×10-3 mm2/s作為閾值,診斷甲狀腺噁性結節的敏感性、特異性分彆為93.3%、96.7%.結論 甲狀腺噁性病變的ADC值低于良性病變.DWI和ADC值在甲狀腺結節病變的鑒彆診斷中具有重要價值.
목적 탐토자공진미산가권성상대갑상선량악성결절적감별진단개치.방법 수집2004년11월지2006년2월재천진의과대학총의원급종류의원취진적갑상선결절병변환자.채용평면회파성상기술대60례갑상선결절병변(량악성각30례)행DWI검사,분별측량b치취0화100、200、300、400 s/mm2시병변적ADC치,비교기간차이.소유병변균경수술병리증실.결과 당선취불동적b치시,소측득적량、악성결절적ADC치지간균재통계학차이,차악성결절조적ADC치소우량성결절조적ADC치(P＜0.05).근거겸고DWI도상적신조비화능구준학측량ADC치적원칙,재다충b치적DWI검사중,의선택400 s/mm2작위검사갑상선결절성병변적최가b치.당b치선택400 s/mm2시,회제ROC곡선,병선취ADC치1.475×10-3 mm2/s작위역치,진단갑상선악성결절적민감성、특이성분별위93.3%、96.7%.결론 갑상선악성병변적ADC치저우량성병변.DWI화ADC치재갑상선결절병변적감별진단중구유중요개치.
Objective To investigate the value of magnetic resonance diffusion weighted imaging (DWI) in the differential diagnoses of malignant and benign thyroid lesions. Methods Using echo planner imaging sequence with b value of 0, 100, 200, 300 and 400 s/mm2 respectively, DWI was performed in 60 patients of focal thyroid lesions. The diagnosis was confirmed by pathological examination (benign, n =30; malignant, n =30). Apparent diffusion coefficient (ADC) values were measured. The differences were analyzed between two groups. Results With b value of 0, 100, 200, 300 and 400 s/mm2 respectively,there were statistical differences in ADC values between benign and malignant lesions. The ADC value of malignant lesions was smaller than that of benign lesions (P ＜ 0. 05). Among different b values, 400 s/mm2 was the most optimal one to diagnose thyroid nodular lesions. DWI with a b value of 400 s/mm2 had a proper signal-to-noise ratio (SNO). And ADC value could be measured correctly. With a b value of 400 s/mm2 and ADC of 1. 475 × 10-3 mm2/s, receiver operating characteristic curve was plotted. In the diagnosis of malignant lesions, the sensitivity and specificity were 93.3% and 96.7% respectively. Conclusions The ADC value of malignant thyroid nodular lesions is smaller than that of benign lesions. The values of DWI and ADC are important in the differential diagnoses of nodular thyroid lesions.
