磁共振成像2025，Vol.16Issue(5)：136-142,7.DOI:10.12015/issn.1674-8034.2025.05.021
弥散峰度成像联合常规MRI在甲状腺良恶性结节鉴别诊断中的价值
Value of diffusion kurtosis imaging combined with conventional MRI in the differential diagnosis of benign and malignant thyroid nodules
摘要
Abstract
Objective:To assess the diagnostic value of unenhanced MRI with diffusion kurtosis imaging(DKI)in differential diagnosis between thyroid benign and malignant nodules.Materials and Methods:A total of 96 consecutive patients,each with a single thyroid nodule,were included in this study.Among these,39 nodules were histopathologically confirmed as benign,while 57 were malignant.All patients underwent thyroid MRI,which included T1-weighted imaging(T1WI),T2-weighted imaging(T2WI),diffusion-weighted imaging(DWI),and DKI.Two radiologists independently evaluated the images,measuring the signal intensity ratio(SIR)on T1WI and T2WI,the apparent diffusion coefficient(ADC)from DWI,as well as mean diffusivity(MD)and mean kurtosis(MK)from DKI.Additionally,morphological features of the nodules were assessed.Univariate and multivariate logistic regression analyses were performed to determine the predictive value of these imaging parameters and morphological features for malignancy.To assess the robustness of the logistic regression model,a 5-fold cross-validation approach was applied.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic effectiveness of the continuous variables that were statistically significant in the multivariate analysis.Results:The characteristics of thyroid malignant nodules including lower ADC values(P＜0.001),lower MD values(P＜0.001),higher MK values(P＜0.001),younger age(P＜0.001),smaller tumor size(P＜0.001),solid component(P＜0.001),and irregular margins(P＜0.001).Multivariate analysis further revealed that lower MD values(odds ratio=5.046;P=0.001),smaller tumor size(odds ratio=3.817;P=0.001),and irregular margins(odds ratio=84.876;P＜0.001)were independent risk factors for thyroid malignant nodules.The combined model yielded an average area under the ROC curve of 0.968 in 5-fold cross-validation,with a sensitivity of 91.4％,specificity of 84.6％,accuracy of 88.7％,and an F1 score of 0.904 at the optimal cutoff value of 0.42.Conclusions:MD values derived from DKI,combined with morphological features can provide imaging diagnostic basis for the preoperative differential diagnosis between thyroid benign and malignant nodules.关键词
甲状腺结节/甲状腺癌/磁共振成像/弥散峰度成像/鉴别诊断Key words
thyroid neoplasms/thyroid carcinoma/magnetic resonance imaging/diffusion kurtosis imaging/differential diagnosis分类
医药卫生引用本文复制引用
唐启瑛,刘信攸,姜秋利,朱柳红,周建军..弥散峰度成像联合常规MRI在甲状腺良恶性结节鉴别诊断中的价值[J].磁共振成像,2025,16(5):136-142,7.基金项目
Natural Science Foundation of Fujian Province(No.2022J011425) （No.2022J011425）
Health and Technology Project of Fujian Province(No.2022QNB020). 福建省自然科学基金项目(编号:2022J011425) （No.2022QNB020）
福建省卫生健康科技计划项目(编号:2022QNB020) （编号:2022QNB020）
