الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Thyroid nodules are a common clinical problem. Their incidence increases on ultrasound to reach 18%-68% of asymptomatic individuals. The most important aspect of management of thyroid nodules is excluding malignancy which occurs in 5-15% of all thyroid nodules, Since the most common presentation of thyroid cancer is the presence of asymptomatic thyroid nodule or mass.
Different imaging modalities play a role in diagnosing thyroid nodules; ultrasound remains the most common sensitive and non-invasive diagnostic imaging modality for thyroid lesions, however, MRI with DWI is emerging as another non-invasive imaging modality for differentiating benign from malignant lesions, helping in tumor staging and detection of post-operative recurrent or residual masses.
The aim of our study was to evaluate the role of diffusion weighted MRI in primarily differentiating between benign and malignant thyroid nodules, and expecting the aggressiveness of the malignant lesion when possible, correlating the results with histopathology as the gold standard.
The current study included 23 patients with suspicious thyroid lesions referred from the endocrinology, Otorhinolaryngology and head and neck surgery departments to the Radiology department of Alexandria Main University Hospitals within the time interval from June 2020 to June 2022, for MRI with DW imaging. The findings were correlated with histopathology results from either FNAC from the thyroid nodules and/or thyroidectomy or excisional biopsy from lymph nodes. Nineteen of the cases were presenting with thyroid swelling under investigation for the first time, the remaining four were presenting with recurrent lesions after thyroidectomy.
The current study detected a statistically significant difference between the mean ADC value of benign and malignant thyroid lesions; mean ADC value for benign cases was found to be 1.79 +- 0.47 x10-3 mm2/sec which is significantly higher than the mean ADC for malignant cases of 0.92 +- 0.34 x10-3 mm2/sec with P-value >0.001. a cut-off value of 1.2 x10-3 mm2/sec was concluded with a diagnostic ability of 88.24% sensitivity and 100 % specificity. This matches with data published from previous studies by Ekinci O et al, Aghaghazvini L, et al and Shokry, A.M. et al published in 2018 and Kong W, et al published in 2019.
Therefore, our study showed that DW-MRI is an important non-invasive diagnostic tool for assessment of thyroid lesions using both qualitative and quantitative methods. It can be used in association with US and FNAC to enhance the diagnostic accuracy in evaluation of suspicious thyroid lesions during preoperative assessment and planning as well as in cases of suspected postoperative recurrence.