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目的:探讨高b值扩散加权成像(DWI)对甲状腺良恶性结节的鉴别诊断价值。方法:选择因甲状腺结节拟行手术治疗58例,术前均常规进行甲状腺DWI检查,分别测量不同b值DWI图像中单个甲状腺结节与邻近正常甲状腺组织的信号强度比值,以及高b值DWI图像与低b值DWI图像中的R值变化情况,再通过与术后病理检查结果对照,评估上述DWI诊断指标对甲状腺良恶性结节的鉴别诊断价值。结果:共有良性结节43个和恶性结节47个纳入结节测量和统计分析。(1)单变量分析结果显示,R值中的R0和R_(2000),以及R值变化类型中的Type-R_(800)/0、Type-R_(2000)/0、Type-R_(2000/800),在甲状腺良恶性结节间均差异显著(P<0.05)。(2)多变量分析结果显示,R_0(敏感度和特异性为83.0%和58.1%)及Type-R_(2000)/0(敏感度和特异性为95.7%和83.7%),可作为甲状腺恶性结节的独立诊断指标(P<0.05和P<0.01);如果将R值和R值变化类型并联诊断,特异性可进一步提高至86.0%。结论:高b值DWI对甲状腺良恶性结节的鉴别诊断价值较高。
Objective: To investigate the differential diagnosis of benign and malignant thyroid nodules with high b value diffusion weighted imaging (DWI). Methods: Fifty-eight cases of thyroid nodules were selected for surgery. Thyroid DWI was performed routinely before surgery. The signal intensity ratio of single thyroid nodules and adjacent normal thyroid tissue in different b-value DWI images were measured, and the high b value DWI Image and low b value of DWI image R value changes, and then compared with postoperative pathological findings, to assess the diagnostic value of DWI diagnostic indicators of benign and malignant thyroid nodules in the differential diagnosis value. Results: A total of 43 benign nodules and 47 malignant nodules were included in nodule measurement and statistical analysis. (1) The results of univariate analysis showed that R0 and R_ (2000) in R value and Type_R_ (800) / 0, Type_R_ (2000) / 0 and Type_R_ (2000) / 800), there was significant difference between benign and malignant thyroid nodules (P <0.05). (2) Multivariate analysis showed that R_0 (sensitivity and specificity of 83.0% and 58.1%) and Type-R_ (2000) / 0 (sensitivity and specificity of 95.7% and 83.7% Nodules were independent diagnostic indicators (P <0.05 and P <0.01); if the R value and R value changes in parallel diagnosis of type, the specificity can be further increased to 86.0%. Conclusion: The high b value of DWI in the differential diagnosis of benign and malignant thyroid nodules is of high value.