The Application Of Diffusion-Weighted Imaging Associated With Dynamic Contrast-Enhanced MR In Differential Diagnosis Of Benign And Malignant Thyroid Nodules At 3.0T

Objective:To explore the application of diffusion-weighted imaging associated with dynamic contrast-enhanced MR in the differential diagnosis of benign and malignant thyroid nodules at 3.0T,and to find independent predictors.Methods:132 patients with thyroid nodules who had undergone preoperative DWI and DCE-MRI in in our hospital from August 2017 to January 2020 were analyzed retrospectively.The chi-square test and the Student t test were used to evaluate the relationship between MRI quantitative and semiquantitative parameters(ADC value,TIC curve type,Maximum Enhancement,Relative Enhancement,Maximum Relative Enhancement,T0-Time of Arrival,Time to Peak,Wash in Rate,Wash out Rate and Brevity of Enhancement)and thyroid nodule benign and malignant.Multivariate logistic regression analysis was performed to identify the independent predictors and to establish a combined model.ROC was done to evaluate the predictive performance of the model.Results:A total of 132 patients were enrolled,including 56 benign nodules and 76 malignant nodules.ADC value,Maximum Enhancement,Time to Peak,TIC curve type,Wash in Rate and Wash out Rate identified significantly associated with benign and malignant thyroid nodules.Multivariate regression analysis showed that ADC value(OR=1.055,95%CI:1.028-1.083),TIC curve type(OR = 0.046,95% CI: 0.015-0.147)and Maximum Enhancement(OR =1.001,95% CI: 1.000-1.002)were independent predictors for benign and malignant thyroid nodules.The combined model achieved an area under ROC curve of0.934,sensitivity of 85.7%,and specificity of 88.5%.Conclusions:The ADC value,TIC curve type and Maximum Enhancement are independent predictors of benign and malignant thyroid nodules.The combination of the three is helpful for the differential diagnosis of preoperative thyroid nodules.