| 任杰,狄鑫,沈智威,岳云龙.不同b值表观弥散系数直方图参数鉴别甲状腺良、恶性结节[J].中国医学影像技术,2022,38(10):1561~1566 |
| 不同b值表观弥散系数直方图参数鉴别甲状腺良、恶性结节 |
| Apparent diffusion coefficient histogram parameters obtained with different b values for differentiating benign and malignant thyroid nodules |
| 投稿时间：2022-04-26 修订日期：2022-06-30 |
| DOI：10.13929/j.issn.1003-3289.2022.10.026 |
| 中文关键词: 甲状腺肿瘤 磁共振成像 表观弥散系数 直方图 |
| 英文关键词:thyroid neoplasms magnetic resonance imaging apparent diffusion coefficient histogram |
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| 中文摘要: |
| 目的 观察以不同b值获得的表观弥散系数（ADC）直方图参数鉴别甲状腺良、恶性结节的效能。方法 回顾性分析43例单发甲状腺结节患者，术后病理确诊良性22例（良性组）、恶性21例（恶性组）；将其术前5个b值（0、200、400、600和990 s/mm2）弥散加权成像（DWI）图导入ITK-snap软件，于b值为990 s/mm2的DWI上手动勾画ROI，利用自编程序分别计算ROI内不同b值的ADC百分位数（ADC 5%、25%、50%、75%、95%）、平均值、偏度及峰度，绘制直方图曲线；以受试者工作特征（ROC）曲线分析ADC直方图参数鉴别甲状腺良、恶性结节的效能。结果 b值为400、600、990 s/mm2时，良性组ADC 5%、50%、75%及平均值均高于恶性组（P均<0.05）；b值为200、400、600、990 s/mm2时，良性组ADC 25%高于恶性组（P均<0.05）；b值为600、990 s/mm2时，良性组ADC 95%高于恶性组（P均<0.05）；其余参数组间差异均无统计学意义（P均>0.05）。上述组间差异具有统计学意义的ADC直方图参数中，b值为990 s/mm2时的ADC平均值鉴别良、恶性结节的曲线下面积（AUC）最大，为0.751；b值为990 s/mm2时的ADC平均值、ADC 95%的诊断敏感度最高，均为81.04%；b值为990 s/mm2时的ADC 50%诊断特异度最高，为86.43%。结论 b值为200、400、600尤其990 s/mm2获得的ADC直方图参数可用于鉴别甲状腺良、恶性结节。 |
| 英文摘要: |
| Objective To observe the efficacy of apparent diffusion coefficient (ADC) histogram parameters obtained with different b values for differential diagnosis of benign and malignant thyroid nodules. Methods Totally 43 patients with solitary thyroid nodule were retrospectively analyzed, including 22 cases of benign (benign group) and 21 cases of malignant (malignant group) confirmed by postoperative pathology. All patients underwent diffusion weighted imaging (DWI) with 5 b values (0, 200, 400, 600, and 990 s/mm2) before operation. The images were imported into ITK-snap software, and ROI of lesions were manually delineated on DWI images with b value of 990 s/mm2. The ADC percentiles (ADC 5%, 25%, 50%, 75%, 95%), ADC mean value, skewness and kurtosis of different b values of ROI were calculated using self-written program, and the histogram curve was drawn. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of ADC histogram parameters for distinguishing benign and malignant thyroid nodules. Results When b value was 400, 600 and 990 s/mm2, the ADC 5%, 50%, 75% and mean values in benign group were higher than those in malignant group (all P<0.05). When b value was 200, 400, 600 and 990 s/mm2, the ADC 25% of benign group were all higher than that in malignant group (all P<0.05).When b value was 600 and 990 s/mm2, the ADC 95% in benign group were all higher than that in malignant group (both P<0.05). No significant difference of other parameters was found between groups (all P>0.05). Among the above ADC histogram parameters being significant different between groups, when b value was 990 s/mm2, the area under the curve (AUC) of ADC mean value for differentiating benign and malignant nodules was the largest (0.751), and when b value was 990 s/mm2, ADC mean value and ADC 95% diagnostic sensitivity were the highest (both 81.04%).When b value was 990 s/mm2, ADC 50% had the highest diagnostic specificity (86.43%). Conclusion ADC histogram parameters obtained with b value of 200, 400, 600 and 990 s/mm2, esp. those with b value of 990 s/mm2, could be used to distinguish benign and malignant thyroid nodules. |
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