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扩散权重MRI的定量评估,以区分大于4厘米的良性和恶性甲状腺结节

Tingting Zheng¹, Xiaoli Xie², Zhaoxian Ni³

¹Department of Radiology, Minhang Hospital, Fudan University, No 170, Xinsong Road, Minhang District, Shanghai, 201199, China.

BMC medical imaging

|December 13, 2023

概括

定量扩散加权成像 (DWI) 有效诊断出恶性甲状腺结节. 结合DWI信号强度比 (SIR) 和最小明显扩散系数 (ADCmin) 模型,显著减少了不必要的活检,显示出高诊断性能.

科学领域:

放射学放射学是一门学科.
在瘤学瘤学.
医疗成像医学成像

背景情况:

甲状腺结节很常见,区分良性和恶性结节对于适当的患者管理至关重要.
准确诊断甲状腺结节,特别是较大的 (>4厘米),可以挑战传统的成像技术.

研究的目的:

评估定量扩散权重成像 (DWI) 分析的诊断疗效,以区分良性与恶性甲状腺结节大于4厘米.
开发和验证使用DWI参数的预测模型,以提高诊断准确度和减少不必要的活检.

主要方法:

使用定量DWI和明显扩散系数 (ADC) 参数对82个甲状腺结节 (62个良性,20个恶性) 的回顾性分析.
计算信号强度标准偏差 (DWI_SD,ADC_SD),信号强度比 (DWI_SIR,ADC_SIR),平均ADC (ADC_平均),最小ADC (ADC_min),以及ADC值标准偏差 (ADC_VSD) 的方法.
使用后勤回归和ROC分析来确定预测因素,并将模型性能与ACR-TIRADS进行比较.

主要成果:

多变量分析确定DWI_SIR和ADC_min作为恶性瘤的独立预测因子 (P<0.001).
结合的DWI_SIR和ADC_min值模型实现了0.875的ROC曲线 (AUC) 下的高面积,超过了ACR-TIRADS (AUC = 0.722).
综合的DWI_SIR和ADC_min模型显示,没有必要的活检率为0%,明显低于ACR-TIRADS (56.3%).

结论:

定量DWI分析为恶性甲状腺结节提供了有利的诊断效果.
结合DWI_SIR和ADC_min的值模型显著提高了诊断性能,并大大降低了不必要的活检率.

关键词:

良性和恶性良性和恶性扩散权重成像技术的使用.大型甲状腺结节定量评价定量评价定量评价定量评价

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