DCE-MRI定量参数联合小视野弥散加权成像对甲状腺良恶性结节鉴别的价值OA北大核心CSTPCD

Objective:To explore the value of dynamic contrast enhanced-magnetic resonance imaging(DCE-MRI)quantitative parameters combined with reduced field-of-view diffusion-weighted magnetic resonance imaging in the differentiation between benign and malignant thyroid nodules.Materials and Methods:From January 2022 to October 2023,a total of 38 thyroid nodule patients(52 nodules)were collected,which were diagnosed by surgery and pathology in the Affiliated Hospital of Binzhou Medical College.They were divided into benign nodule group and malignant nodule group.Before operation,all patients underwent 3.0 T MRI scanning,including conventional MRI,reduced field-of-view diffusion-weighted magnetic resonance imaging(b value was 0,800 s/mm2)and DCE-MRI examination,and their apparent diffusion coefficient(ADC)value and quantitative parameters of DCE-MRI were measured,including contrast blood plasma and extravascular extracellular space(Ktrans),rate constant between extravascular extracellular space and blood plasma(Kep)and Volume of extravascular extracellular space per unit volume of tissue(Ve).The ADC,Kep,Ve and Ktrans of thyroid benign and malignant nodules were analyzed by independent sample t test,and the difference was statistically significant(P<0.05).Then,stepwise logistic regression model was used to analyze the independent predictors of benign and malignant nodules.And draw receiver operating characteristic(ROC)curve to analyze the diagnostic efficiency of ADC,Kep and Ktrans independent diagnosis model and joint ADC and Ktrans diagnosis model.Results:The average ADC value,Ktrans value,Kep value in benign nodules group were(1.659±0.370)×10-3 mm2/s,(0.427±0.214)min-1,(0.966±0.225)min-1,respectively.While the average ADC value,Ktrans value,Kep value in malignant nodules group were(1.182±0.195)×10-3 mm2/s,(0.178±0.073)min-1,(0.600±0.248)min-1,respectively.The value of ADC,Kep and Ktrans in benign nodules group were higher than those in malignant nodule group,and the differences were statistically significant(P<0.001).The independent sample t test and stepwise logistic regression analysis showed that there had a difference between ADC value and Ktrans value(P<0.05).And they were independent predictors for differentiating benign from malignant thyroid nodules.The area under the curve(AUC)of ADC alone was 0.915,and the AUC of Ktrans alone was 0.827.The AUC of the combined model of ADC value and Ktrans was 0.973,which was significantly higher than that of the single application of ADC value and Ktrans,and the diagnostic efficiency of the combined diagnosis model was the highest.According to the DeLong test,there was statistical difference between the combined diagnosis model and Ktrans diagnosis alone(P<0.05).The combined diagnostic model of ADC value and Ktrans had a sensitivity of 97.3%,which was higher than ADC and Ktrans,and a specificity of 84.6%,which was higher than ADC value.Conclusions:ADC value and Ktrans are important parameters for differentiating benign and malignant nodules.The combined model of ADC value and Ktrans can assist clinical practice and provide an important basis for preoperative diagnosis.