弥散加权成像对甲状腺结节性病变诊断价值初探

The pre-suggestion of diagnostic value for thyroid nodule in diffusion-weighted imaging

目的以B超检查及细针抽吸活检(Fine needle aspiration biopsy FNAB)为标准,探讨弥散加权成像(diffu-sion-weighted imaging DWI)对甲状腺结节良恶性的判断。方法选取2008年4月～2011年3月77例经B超检查发现甲状腺结节的患者以及20例B超确诊正常的患者对其进行甲状腺DWI检查,所选取的b值分别为100、200、300 mm2/s,对其进行ADC值的测量,并对结果进行对比分析。结果甲状腺良、恶性结节在不同b值条件下(100、200、300)的范围分别为(1.28～3.89、0.29～1.96、0.59～3.06×10-3mm2/s与(0.13～1.21、0.31～1.98、0.10～0.59)×10-3mm2/s;甲状腺良性结节的ADC值要高于恶性结节的ADC值,二者差异有统计学意义(P<0.05)。正常甲状腺ADC值与患甲状腺结节疾病患者的正常甲状腺部分的ADC值无明显差异(P>0.05)。结论良性结节的ADC值高于恶性结节,DWI序列有助于甲状腺结节性质的判断。

Objective Determining the diagnostic role of diffusion-weighted imaging(DWI) in the differentiating of malignant and benign thyroid nodules by using fine needle aspiration biopsy cytology criteria as a reference standard.Methods Between Apr 2008 and March 2011,77 consecutive patients with ultrasound-diagnosed thyroid nodules and 20 healthy subjects underwent DWI.A total of nodules were included in the study using the following b factors 100,200,and 300 mm2/s.ADC values in all subjects were calculated and compared using suitable statistical nalysis.Results Mean ADC values for benign and malignant nodules were(1.28~3.89、0.29 ~1.96、0.59~3.06)×10-3 mm2/s and(0.13~1.21、0.31~1.98、0.10~0.59)×10-3 mm2/s.Mean ADC values of malignant nodules were lower than benign nodules.There were significant differences in ADC values.The ADC values among normal-appearing thyroid parenchyma of patients and normal-appearing thyroid parenchyma of healthy subjects were insignificant differences.Conclusion Benign nodules have higher ADC values than malignant ones.DWI may be helpful in differentiating malign and benign thyroid nodules.