| Background:diffusion weighted imaging (DWI), in foreign arisen, such people since 1990 Mispec since application, with reports for more than ten years, the research progress on the increasingly mature DWI technology, its first application in the central nervous field, in recent years has been widely used in the breast, thyroid, pelvic tumor, systemic lymphadenopathy etc, and in the way the choice of methods and the influence factors on the progress achieved significant study. The main principle is within the organization of observations to determine water Brownian motion within the organization to how much water content, the pathophysiological further judgment organization for change, its diagnosis lymph node metastases can provide traditional MRI can provide information. Domestic and overseas scholars for thyroid neoplasm and neck lymphadenopathy all has more research, but will thyroid neoplasms and lymph node metastases together there a comparative study of the related research at home and abroad. And with the ultrasound, CT, DWI comparative study of nuclide is relatively rare.Objective:1. Contrast DWI and doppler ultrasound, CT, thyroid carcinoma of nuclide transport in diagnosis of cancer cervical lymph node metastases evaluate.2) to investigate the above four examination, and the clinical significance of clinical indications.3. Explore ADC values for differentiating benign and malignant lymph node significance.Methods:select the same group of thyroid cancer patients with cervical lymph node enlargement application ROC curves analysis ultrasound, CT, DWI nuclide transport, strengthen inspection identify lymph nodes in the neck benign and malignant accuracy. The comparison and analysis of the disadvantages of several check and applicable case. Measurement of the lymph nodes, the primary lesion, discusses the ADC values to identify the value of benign and malignant lymph node.Results:the application of ultrasound, CT, DWI test area under the ROC curves 0.924, respectively 0.762,0.793, ultrasound contrast CT, DWI are respectively for p< 0.01, DWI and CT contrast p= 0.13; CT, DWI and ultrasound examination of sensitivity and specific degrees 79.5%, respectively 81.0% 83.2% and 87.8% 80.3%, with,92.0%. Results show that the diagnosis accuracy DWI check with CT quite, the difference was statistically significant, ultrasound diagnostic accuracy is better than DWI and CT. Malignant lymph node group for the average ADC values 1.693 and x 10 0.456) (a 3mm2/s, benign lymph node group for the average ADC values 1.499 and x10 0.456) (a 3mm2/s, both the difference between ADC values are statistically significant (P< 0.01), primary cancer for the average ADC values focal 1.723 and a/s, 3mm2 0.43 with malignant lymph node group differences between the ADC values was not statistically significant (P> 0.01), and the benign lymph node group differences between the ADC values are statistically significant (P< 0.01).Conclusion:1. This study with pathological diagnosis at home for the first time to differentiated thyroid cancer compared the cervical lymph node metastases DWI and ultrasound, CT and radionuclide contrast, and discusses the value of clinical applications.2. Research shows that the neck DWI have images with low, around the imaging resolution anatomical structure contrast the poor quality, and to the regular MRI or 3D-FIESTA etc coronary TLC scanning combined application so as to improve the display effect and positioning lesions ability.3. DWI examination and CT diagnosis accuracy, both there below ultrasound.4. Differentiated thyroid carcinoma benign lymph node average ADC values below the average ADC values malignant lymph nodes, there exist significant differences between the two. Its mechanism is still unknown. |
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