3.0T磁共振成像在甲状腺良恶性病变鉴别诊断中的价值研究

The differential diagnostic value of 3.0T magnetic resonance imaging in benign and malignant thyroid lesions

目的探讨磁共振成像在甲状腺良恶性病变鉴别中的应用价值。方法研究对象为2010年8月～2011年8月我院收治的甲状腺病变48例患者、54个病灶,经Philips 3.0T磁共振成像,比较分析T1WI、T2WI、DWI(b值为150、300和500s/mm2)及动态增强中良性病灶及恶性病灶的MRI表现,并与病理对照。结果 T1WI像良性病变呈等及略高信号,恶性病变为不均匀略高信号;T2WI像良恶性病变均为略高信号,无统计学差异(P>0.05);DWI成像(良性病变:b值为150时ADC值为2.489±0.442、b值为300时ADC值为1.974±0.369、b值为500时ADC值为1.649±0.445;恶性病变:b值为150时ADC值为1.733±0.326、b值为300时ADC值为1.399±0.258、b值为500时ADC值为1.214±0.302),具有统计学差异(P<0.05)。T1WI动态增强良性病变呈流出型强化曲线,恶性病变呈延迟性消退型曲线,具有一定特征性。结论磁共振成像对甲状腺良恶性病变鉴别应用价值高,尤其是ADC值对良恶性病灶的鉴别意义较大。

Objective To study the diagnostic value of magnetic resonance imaging in benign and malignant thyroid le- sions. Methods 48 patients with 54 thyroid lesions were examined by Philips 3.0 T magnetic resonance imaging. To ana- lyze their findings on T1WI, TzWI, DWI （b=150, 300 and 500 s/mm2） and dynamic contrast enhanced MRI, and com- pare them with pathology. Results Benign lesions were slightly hyperintense or equal to the signal on T1WI, and malig- nant lesions were slightly hyperintense and inhomogeneous. Both benign and malignant lesions were slightly hyperintense on T2WI. Which were not statistically significant （ P 〉 0.05） ; When b=150 s/mm2, 300 s/mm2 , 500 s/mm2 , the be- nign lesions＇ ADC values were respectively of 2. 489 ± 0. 442, 1. 974 ± 0. 369, 1. 649 ± 0. 445 and the malignant le- sions＇ ADC values were respectively of 1. 733 ±0. 326, 1. 399 ± 0. 258, 1. 214 ± 0. 302 on DWI, which was statistically significant （ P 〈0.05）. There was a certain characteristic on dynamic contrast-enhanced T1WI that benign lesions showed outflow-strengthening curve and malignant lesions showed delayed subsided eurve. Conclusion Magnetic resonance ima- ging has highly diagnostic value for benign and malignant thyroid lesions, especially the ADC values.