学术论文

      IVIM理论中各参数值在甲状腺良恶性结节方面的鉴别诊断价值

      Each parameter value in differential diagnosis of benign and malignant thyroid nodules under IVIM theoretical aspects

      摘要:
      目的:探讨体素内不相干运动(IVIM)理论各参数值在甲状腺良恶性结节方面的鉴别诊断价值.方法:收集甲状腺结节欲行手术患者25例(其中结节共31个)及正常对照组10例,术前行GE 3.0T常规MRI平扫及多个b值扩散加权扫描(b=0、10、20、50、100、200、400、800、1 200 mm2/s),测量结节患者及正常对照者在IVIM理论中的D值,D*值及F值.绘制ROC曲线并比较分析这些值在鉴别甲状腺良恶性结节方面的价值.结果:术后病理证实31个结节中,良性结节18个(结节性甲状腺肿12个,腺瘤6个),甲状腺乳头状癌13个.正常甲状腺组织、良性结节及乳头状癌3组的D值两两比较分别有统计学差异,F值无明显统计学差异.正常对照组与良性结节组、正常对照组与乳头状癌组D*值有统计学差异,良性结节组与乳头状癌组D*值无明显统计学差异(P>0.05).取D=1.68×10-3 mm2/s为鉴别良恶性结节的临界值,敏感度为77.8%,特异度为90.9%.结论:IVIM理论下的参数D值对甲状腺良恶性结节的鉴别诊断有重要帮助及价值.
      Abstract:
      Objective:To study the value of each parameter in IVIM theory in the differential diagnosis of benign and malignant thyroid nodules.Methods:Totally 25 patients with thyroid nodules undergoing surgery (31 nodules) and a normal control group of 10 samples underwent GE 3.0T routine MRI scan and multiple b value diffusion weighted scan (b=0,10,20,50,100,200,400,800,1 200 mm2/s) before operation,D value,D* value and F value in the theory of IVIM of the patients and members in normal control group were measured.ROC curve was drawn,the parameters were compared in the differential diagnosis of benign and malignant thyroid nodules.Results:Eighteen of 31 thyroid nodules were benign nodules with nodular goiter in 12 cases and adenoma in 6 cases,and 13 were thyroid papillary carcinoma which had been pathologically confirmed.D values were statistically significant differences between each other,among the three groups,namely normal control group,benign nodule group and papillary carcinoma group.F values were no significant differences.D* values were significant differences between benign nodule group and normal control group.D* values were also significant differences between normal control group and papillary carcinoma group.D* values were no significant differences between benign nodule group and papillary carcinoma group (P>0.05).Taken D=1.68×10-3 mm2/s as threshold for diagnosing benign and malignant nodules,sensitivity was 77.8%,specificity was 90.9%.Conclusion:D value in IVIM theory has important value for the differential diagnosis of benign and malignant thyroid nodules.
      Author: SU Yu GAO Si-jia CAO Ji-bin XIE Ming-fei
      作者单位: 中国医科大学附属第一医院放射科,辽宁沈阳,110001
      刊 名: 中国临床医学影像杂志 ISTICPKU
      年,卷(期): 2017, 28(3)
      分类号: R581 R445.2
      在线出版日期: 2017年4月12日