Investig Magn Reson Imaging.  2015 Dec;19(4):224-230. 10.13104/imri.2015.19.4.224.

Should We Recommend Ultrasonography for an Incidental Thyroid Nodule on Additional Cervicothoracic Sagittal T2-Weighted Image of Lumbar Spine MRI?

• Cho HW
• Park JO
• Lee YH
• Chung SY
• Suh JS

• KMID: 2151769
• DOI: http://doi.org/10.13104/imri.2015.19.4.224

Abstract

PURPOSE
To determine whether we should recommend ultrasonography (US) for an incidental thyroid nodule identified by additional cervicothoracic sagittal T2-weighted image (C-T sag T2WI) of lumbar spine magnetic resonance imaging (MRI).
MATERIALS AND METHODS
A retrospective study of 61 patients who underwent both lumbar spine MRI and thyroid US between December 2011 and April 2015 was conducted. For all US-found thyroid nodules > 1 cm, investigators evaluated whether there was any correlation between thyroid nodule detectability by C-T sag T2WI and US features such as echogenicity, composition, or suspicion of malignancy.
RESULTS
Solid hypoechoic (2/4; 50%) or mixed echoic nodules (4/8; 50%) appeared to be found relatively more easily by C-T sag T2WI than more benign-looking solid isoechoic (1/4; 25%) or spongiform nodules (0/6; 0%). Among six nodules with ultrasonographic suspicion for malignancy, only one nodule was detected by C-T sag T2WI.
CONCLUSION
If an incidental thyroid nodule is seen by C-T sag T2WI, it would be better to recommend thyroid US for identifying malignancy.

Keyword

Cervicothoracic spine; Sagittal T2-weighted image; Lumbar spine MRI; Thyroid nodule; US

MeSH Terms

Humans
Magnetic Resonance Imaging*
Research Personnel
Retrospective Studies
Spine*
Thyroid Gland*
Thyroid Nodule*
Ultrasonography*

Figure

• 

  Fig. 1 A 65-year-old woman with a 12-mm right thyroid nodule. (a) Thyroid US reveals an unparalleled solid hypoechoic thyroid nodule with microcalcifications, which is suspicious for malignancy. The nodule was diagnosed as benign by fine needle aspiration biopsy. (b) After 3 months, C-T sag T2WI of lumbar spine MRI for evaluation of lower back pain shows a T2-high signal intensity nodule in the thyroid (arrow).

• 

  Fig. 2 A 74-year-old woman with a 25-mm right thyroid nodule. (a) The thyroid nodule shows mixed solid and cystic composition in the US. (b) C-T sag T2WI of lumbar spine MRI two days later shows a nodule with cystic component in the thyroid (arrow). It can be mistaken for a much smaller nodule in the MR images.

• 

  Fig. 3 Undetected > 1-cm thyroid nodules. (a, b) A spongiform thyroid nodule of a 55-year-old woman. (c, d) A solid isoechoic thyroid nodule of a 56-year-old woman. These nodules were not identified by C-T sag T2WI of lumbar spine MRI.

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