Tiroid Karsinomu Tanısı – Problem Çözücü Olarak Dinamik Manyetik Rezonans Görüntüleme

Abstract

ÖZ Amaç: Tiroid kanseri olgularının ayırıcı tanısında dinamik manyetik rezonans görüntülemenin (MRG) renkli Doppler US ve İnce İğne Aspirasyon Biyopsisi (İİAB) ile tanısal doğruluğunun karşılaştırılması. Gereç ve yöntem: Çalışma grubu, muayenelerinde tiroid hormon bozuklukları olan 28 kadın ve 6 erkekten oluşuyordu. Toplam 38 nodül incelendi. Radyolojik incelemelerin ardından İİAB ve tiroidektomi uygulandı. Sonuçlar: Dinamik MR'nin karsinom teşhisi için renkli-Doppler US, İİAB ve dinamik MR modaliteleri arasında en yüksek sensitivite ve spesifisiteye sahip olduğu bulundu. Dinamik MR incelemesinde, malign ve benign nodüller arasında, p < 0.05 düzeyinde hesaplanan tepe kontrast sinyal yoğunluğu değerleri (p = 0.018) ve minimum kontrastlı sinyal yoğunluğu değerleri (p = 0.023) arasındaki fark istatistiksel olarak anlamlıydı. Sonuç: Dinamik MRG verilerinin analizi ile tiroid nodüllerinin ayırıcı tanısının yapılabileceğini düşünüyoruz. Malign tiroid nodülleri tipik zaman-sinyal yoğunluk eğrileri göstermekte olup, dinamik MRG'nin radyoloji-patoloji uyumsuzluğu gibi belirli durumlarda tiroid nodüllerinin ameliyat öncesi değerlendirilmesi için değerli olacabileceğine inanıyoruz.

Keywords

• dinamik MR
• tiroid kanseri
• doppler US

Diagnosis of Thyroid Carcinoma - Dynamic Magnetic Resonance Imaging as a Problem Solver

Abstract

Objective: Comparison of the diagnostic accuracy of dynamic magnetic resonance imaging (MRI) with color Doppler US and Fine Needle Aspiration Cytology (FNAC) in the differential diagnosis of thyroid carcinoma cases. Materials and methods: Study group comprised 28 women and 6 men and all of them had thyroid hormone disorders in their routine examinations. 38 nodules were examined. After radiologic examinations, FNAC and thyroidectomy were applied. Results: The dynamic MR was found to have the highest sensitivity and specificity between the color-Doppler US, FNAC, and dynamic MR modalities for the diagnosis of carcinoma. In the dynamic MR examination, the difference between the peak-contrast signal intensity values (p = 0.018) and the minimum-contrast signal intensity values (p = 0.023) calculated at the p < 0.05 level were statistically significant between the malignant and benign nodules. Conclusions: We consider that the differential diagnosis of thyroid nodules can be made by analyzing the dynamic MRI data. Malignant thyroid nodules show typical time-signal intensity curves, and we believe that dynamic MRI will be valuable for preoperative assessment of the thyroid nodules in certain conditions like radiology–pathology mismatch.

Keywords

• thyroid carcinoma
• dynamic mri
• doppler us

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