Abstract
Amaç: Çalışmamızda,
difüzyon ağırlıklı manyetik rezonans görüntüleme (DAG)’nin tiroid nodüllerinin
karakterizasyonundaki yeri araştırılacaktır. Yöntem: Ekim 2010–Nisan 2011 tarihleri arasında, tiroid
nodülüne yönelik ultrasonografi, sintigrafisi yapılan ve ince iğne aspirasyon
sitolojisi (İİAS) planlanan hastalara İİAS öncesinde DAG gerçekleştirildi. DAG
üzerinden lezyonların ‘apparent diffusion coefficient’ (ADC) haritaları
oluşturuldu. Dört ayrı b değeri (b=300sn/mm², b=500sn/mm², b=750sn/mm²,
b=1000sn/mm²) kullanılarak nodüllerin ADC değerleri sitopatoloji sonuçları
bilinmeden ölçüldü. İİAS ve postoperatif histopatoloji sonuçlarına göre toplam
iki malign, 24 benign nodül çalışmaya dahil edildi. Sintigrafi bulguları ADC
değerleri ile karşılaştırıldı. ADC değerlerinden ROC (Reveiver Operating
Characteric) eğrisi oluşturularak sınır değeri elde edilmeye çalışıldı. Bulgular: 24 benign tiroid nodülün
ölçülen ortalama ADC değerleri b=300’de 3547 ± 556 x10-6mm2/sn,
b=500’de 2221 ± 362 x10-6mm2/sn), b=750’de 1483 ± 242 x10-6mm2/sn,
b=1000’de 1115 ± 182x10-6mm2/sn olarak hesaplandı. İki
malign nodülün ortalama ADC değerleri b=300’de 2430±355 x10-6mm2/sn,
b=500’de 1440±205 x10-6mm2/sn, b=750’de 998±144 x10-6mm2/sn,
b=1000’de 715±118 x10-6mm2/sn olarak bulundu. Sonuç: Bizim çalışmamızda,
benign-malign ayrımı için, farklı b değerlerinde sınır değerler oluşturulmaya
çalışıldı. Olgu sayısının azlığı nedeniyle ROC eğrisi oluşturulup istatistiksel
olarak anlamlı sınır değerleri bulunamadı. Ancak postoperatif histopatolojik
incelemeye göre malign bir cm’den büyük nodül çalışmadaki tüm nodüller arasında
en düşük ADC ölçümüne sahip iken bir cm’den küçük malign nodül ise b=750
değeri haricinde benign nodüllere göre düşük ADC değerlerine sahip idi. Her ne
kadar olgu sayısının azlığı önemli bir kısıtlama oluştursa da çalışmamızdaki
bulgular, literatürdeki diğer araştırma sonuçları ile birlikte ele alındığında
DAG’nin tiroid nodüllerinin malign benign ayrımında faydalı olabileceğini
göstermektedir.
Supporting Institution
Mersin Üniversitesi Bilimsel Akademik Proje
Project Number
BAP-TF DTB (BT) 2010-2 TU
References
- 1. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med 1968; 69:537-540.2. Hsu CH, Liu FY, Yen RF, Kao CH: Tc-99m MIBI SPECT in detecting metastatic papillary thyroid carcinoma in patients with elevated human serum thyroglobulin levels but negative I-131 whole body scan. Endocr Res 2003; 29(1):9-15.3. Solbiati L, Osti V, Cova L, Tonolini M. Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol 2001; 11:2411-2424.4. Wang J, Takashima S, Takayama F, et all. Head and neck lesions characterization with diffusion-weighted echo-planar MR imaging. Radiology 2001; 220:621-30.5. Abdel Razek, Soliman N, Elkhammary S, et al. Role of diffusion-weighted MR imaging in cervical lymphadenopaty. Eur Radiol 2006; 16:1468-77.6. Tezuka M, Murata Y, Ishida R, et al. MR imaging of the thyroid: correlation between apparent diffusion coefficient and thyroid gland scintigraphy. J Magn Reson Imaging 2003; 17:163-69.7. Bozgeyik Z, Coskun S, Dagli AF, Ozkan Y, Sahpaz F, Ogur E. Diffusion-weighted MR imaging of thyroid nodules. Neuroradiology 2009; 51:193-198.8. Schueller-Weidekamm C, Kaserer K, Schueller G, Scheuba C, Ringi H, Weber M, Czerny C, Herneth A.M. AJNR Am J Neuroradiol. 2009; 30:417-22.9. Squillaci E, Manenti G, Di Stefano F, Miano R, Strigari L, Simonetti G. Diffusion-weighted MR imaging in the evaluation of renal tumours. J Exp Clin Cancer Res. 2004; 23:39-45.10. Manenti G, Squillaci E, Di Roma M, Carlani M, Mancino S, Simonetti G. In vivo measurement of the apparent diffusion coefficient in normal and malignant prostatic tissue using thin-slice echo-planar imaging. Radiol Med (Torino). 2006 Dec; 111(8):1124-33. Epub 2006 Dec 20. English, Italian.11. Naganawa S, Sato C, Kumada H, İshigaki T, Miura S, Takizawa O. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol 2005; 15:71-78.12. İchikava T, Haradome H, Hachiya J, Nitatori T, Araki T. Diffusion-weighted MR imaging with a single-shot echoplaner sequence: detection and charevterzation of focal hepatic lesions. Am J Roentgenol. 1998; 170:397-402.13. Nakayama T, Yoshimitsu K, Irie H, Aibe H, Tajima T, Shinozaki K, Nishie A, Asayama Y, Kahikara D, Matsuura S, Honda H. Usefulness of the calculated apparent diffusion coefficent value in the differential diagnosis of retroperitoneal masses. J Magn Reson Imaging. 2004; 20:435-442.14. Nasu K, Kuroki Y, Kuroki S, Murakami K, Nawano S, Moriyama N. Diffusion-weighted single shot echoplanar imaging of colorectal cancer using a sensitivity-encoding technique. Jpn J Clin Oncol. 2004; 34:620-626.15.Oertel YC, Oertel JE. Diagnosis of malignant epithelial thyroid lesions: fine needle aspiration and histopthologic correlations. Ann Diagn Pathol 1998; 2:377-400.16. Anderson JR. Tumours. L General features, types and examples. IN: Anderson JR (ed) Muir’s textbook of pathology. 20th edn. Edward Arnold, London. 2001; 12:1-49.17. Razek AA, Sadek AG, Kombar OR, Elmahdy TE, Nada N. Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary throid nodules. AJNR Am J Neuroradiol 2008; 29:563-68.18. Srinivasan A, Dvorak R, Perni K, et al. Differentiation of benign and malignant pathology in the head and neck using 3T apparent diffusion coefficient values:early experience. AJNR Am J Neuroradiol 2008; 29:40-44.19. Szabo BK, Apselin P, Wiberg MK, Bone B. Dynamic MR imaging of the breast analysis of kinetic and morphologic diagnostic criteria. Acta Radiol. 2003 Jul; 44:379.20. Berg WA, Gutierrez L, NessAiver MS, Carter WB, Bhargavan M, Lewis RS, Ioffe OB. Diagnostic Accuracy of mammogarphy, clinical examination, US and MR imaging in preoperative assessment of breast cancer. Radiology 2004; 233:830-849.21. Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 1988; 168:497-505.
Abstract
Aim:
In our study, the role of diffusion-weighted magnetic resonance imaging (DWI)
in the characterization of thyroid nodules will be investigated. Method: Between October 2010 and April
2011, patients who underwent ultrasonography, scintigraphy and fine needle
aspiration cytology (FNAC) for thyroid nodules were performed DWI prior to
FNAC. Apparent diffusion coefficient (ADC) maps of the lesions were established
via DAG. Four separate b-values (b=300 sec/mm², b=500 sec/mm², b=750 sec/mm²,
b=1000 sec/mm²) were used. Scintigraphy findings were compared with ADC values.
The ROC (Reveiver Operating Characteric) curve was obtained from the ADC
values. Results: The measured mean
ADC values of 24 benign thyroid nodules were 3547 ± 556 x10-6mm2 / s at
b=300, 2221±362 x10-6mm2/sec at b=500, 1483±242 x10-6mm2 at b=50. /sec was
calculated as 1115±182x10-6mm2/sec at b=1000. The mean ADC values of 2
malignant nodules were 2430±355x10-6mm2 / s at b=300, 1440±205x10-6mm2/ sec at
b=500, 998±144 10-6mm2/sec at b=750, b=It was found as 715±118 x10-6mm2 / s at
1000. Conclusion: Although the
small number of cases is an important constraint, the findings in our study
suggest that DWI can be useful in the differentiation of malignant benign thyroid
nodules.
Project Number
BAP-TF DTB (BT) 2010-2 TU
References
- 1. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med 1968; 69:537-540.2. Hsu CH, Liu FY, Yen RF, Kao CH: Tc-99m MIBI SPECT in detecting metastatic papillary thyroid carcinoma in patients with elevated human serum thyroglobulin levels but negative I-131 whole body scan. Endocr Res 2003; 29(1):9-15.3. Solbiati L, Osti V, Cova L, Tonolini M. Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol 2001; 11:2411-2424.4. Wang J, Takashima S, Takayama F, et all. Head and neck lesions characterization with diffusion-weighted echo-planar MR imaging. Radiology 2001; 220:621-30.5. Abdel Razek, Soliman N, Elkhammary S, et al. Role of diffusion-weighted MR imaging in cervical lymphadenopaty. Eur Radiol 2006; 16:1468-77.6. Tezuka M, Murata Y, Ishida R, et al. MR imaging of the thyroid: correlation between apparent diffusion coefficient and thyroid gland scintigraphy. J Magn Reson Imaging 2003; 17:163-69.7. Bozgeyik Z, Coskun S, Dagli AF, Ozkan Y, Sahpaz F, Ogur E. Diffusion-weighted MR imaging of thyroid nodules. Neuroradiology 2009; 51:193-198.8. Schueller-Weidekamm C, Kaserer K, Schueller G, Scheuba C, Ringi H, Weber M, Czerny C, Herneth A.M. AJNR Am J Neuroradiol. 2009; 30:417-22.9. Squillaci E, Manenti G, Di Stefano F, Miano R, Strigari L, Simonetti G. Diffusion-weighted MR imaging in the evaluation of renal tumours. J Exp Clin Cancer Res. 2004; 23:39-45.10. Manenti G, Squillaci E, Di Roma M, Carlani M, Mancino S, Simonetti G. In vivo measurement of the apparent diffusion coefficient in normal and malignant prostatic tissue using thin-slice echo-planar imaging. Radiol Med (Torino). 2006 Dec; 111(8):1124-33. Epub 2006 Dec 20. English, Italian.11. Naganawa S, Sato C, Kumada H, İshigaki T, Miura S, Takizawa O. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol 2005; 15:71-78.12. İchikava T, Haradome H, Hachiya J, Nitatori T, Araki T. Diffusion-weighted MR imaging with a single-shot echoplaner sequence: detection and charevterzation of focal hepatic lesions. Am J Roentgenol. 1998; 170:397-402.13. Nakayama T, Yoshimitsu K, Irie H, Aibe H, Tajima T, Shinozaki K, Nishie A, Asayama Y, Kahikara D, Matsuura S, Honda H. Usefulness of the calculated apparent diffusion coefficent value in the differential diagnosis of retroperitoneal masses. J Magn Reson Imaging. 2004; 20:435-442.14. Nasu K, Kuroki Y, Kuroki S, Murakami K, Nawano S, Moriyama N. Diffusion-weighted single shot echoplanar imaging of colorectal cancer using a sensitivity-encoding technique. Jpn J Clin Oncol. 2004; 34:620-626.15.Oertel YC, Oertel JE. Diagnosis of malignant epithelial thyroid lesions: fine needle aspiration and histopthologic correlations. Ann Diagn Pathol 1998; 2:377-400.16. Anderson JR. Tumours. L General features, types and examples. IN: Anderson JR (ed) Muir’s textbook of pathology. 20th edn. Edward Arnold, London. 2001; 12:1-49.17. Razek AA, Sadek AG, Kombar OR, Elmahdy TE, Nada N. Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary throid nodules. AJNR Am J Neuroradiol 2008; 29:563-68.18. Srinivasan A, Dvorak R, Perni K, et al. Differentiation of benign and malignant pathology in the head and neck using 3T apparent diffusion coefficient values:early experience. AJNR Am J Neuroradiol 2008; 29:40-44.19. Szabo BK, Apselin P, Wiberg MK, Bone B. Dynamic MR imaging of the breast analysis of kinetic and morphologic diagnostic criteria. Acta Radiol. 2003 Jul; 44:379.20. Berg WA, Gutierrez L, NessAiver MS, Carter WB, Bhargavan M, Lewis RS, Ioffe OB. Diagnostic Accuracy of mammogarphy, clinical examination, US and MR imaging in preoperative assessment of breast cancer. Radiology 2004; 233:830-849.21. Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 1988; 168:497-505.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Project Number | BAP-TF DTB (BT) 2010-2 TU |
| Publication Date | December 31, 2019 |
| Submission Date | July 16, 2019 |
| Acceptance Date | September 12, 2019 |
| Published in Issue | Year 2019 Volume: 12 Issue: 3 |
Cite
MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.
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