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

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、T2 WI、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 T1 WI像良性病变呈等及略高信号,恶性病变为不均匀略高信号；T2 WI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士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.

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

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.