摘要
目的分析磁共振背景抑制弥散加权成像（DWIBS）对甲状腺癌淋巴结转移的评估运用价值，为甲状腺癌淋巴结转移的早期诊断提供依据。方法选取我院2011年1月～2013年7月经手术病理证实的40例甲状腺癌病例，对比、分析高分辨率MRI平扫、DWIBS及增强检查在判断甲状腺癌淋巴结转移中的效果。结果40例病例经病理证实共发现29例淋巴结转移，其中10例单分区转移，19例多分区转移；平扫T2WI、增强T1WI、DWIBS转移灶总检出率分别为65．22％、75．36％和82．61％，DWIBS检出率显著高于平扫T2WI、增强T1WI（P〈0．05）：以正常甲状腺作为对照，肿瘤实质、转移淋巴结ADC值显著低于正常甲状腺，瘤内坏死区域ADC值显著高于后者（P〈0．05）；以淋巴结区域作为鉴别诊断的阈值时，DWIBS灵敏度为96．8％，其特异度为91．0％，曲线下面积Az=0．915（P〈0．05），诊断效果较好。结论DWIBS同时结合高分辨率MRI技术，能敏感地发现淋巴结，有助于提高甲状腺癌T分期和N分期的准确性，值得临床推广运用。
Objective To analyze the application value of diffusion weighted imaging with background suppression （DWIBS） in the evaluation of lymph node metastasis in thyroid carcinoma, in order to provide the basis for the early diagnosis of lymph node metastasis in thyroid carcinoma. Methods All of 40 cases with thyroid carcinoma confirmed by operation pathology in our hospital from January 2011 to July 2013 were selected, and the effect of high resolution MRI scan, DWIBS and enhanced examination in judging lymph node metastasis in thyroid carcinoma were compared and analyzed. Results 29 cases were confirmed lymph node metastasis by pathology in all 40 cases, including 10 cases of single partition metastasis, 19 cases of multi partition metastasis. The detection rate of metastasis by T2WI scan, T1WI enhanced scan, DWIBS were 65.22%, 75.36% and 82.61% respectively, the detection rate of metastasis by DWIBS was significandy higher than that by T2WI scan and T1WI enhanced scan （P〈0.05）. The normal thyroid was used as control, the ADC value of tumor parenchyma and metastatic lymph nodes were significantly lower than that of normal thyroid, while the ADC value of tumor necrotic area was significantly higher than that of normal thyroid （P〈 0.05）. When the lymph node regions were as the threshold of differential diagnosis, the sensitivity, specificity and area under the curve （Az） of DWIBS was 96.8%, 91.0% and 0.915 respectively （P〈0.05）, and DWIBS had a good diagnosis effect. Conclusion DWIBS combined with high resolution MRI technology can sensitively detect the lymph node, and help to improve the accuracy of T staging and N staging of thyroid carcinoma, and is worthy of clinical application.
出处
《中国现代医生》
2013年第36期64-66,F0003,共4页
China Modern Doctor
基金
浙江省温州市医药卫生科研项目(2013B46)
关键词
磁共振成像
背景抑制
弥散加权成像
甲状腺癌
淋巴结转移
Magnetic resonance imaging
Background suppression
Diffusion weighted imaging
Thyroid carcinoma
Lymph node metastasis
