J Korean Soc Radiol.  2011 Nov;65(5):433-439.

Characteristic Dynamic Enhancement Pattern of Magnetic Resonance Imaging for Malignant Thyroid Tumor: A Preliminary Report

• Park YN
• Hwang HY
• Shim YS
• Byun SS
• Choi HY
• Kim HS

Abstract

PURPOSE
The purpose of this study is to determine the characteristic dynamic enhancement pattern of magnetic resonance (MR) imaging for malignant thyroid tumor.
MATERIALS AND METHODS
Eight patients who were pathology proven to have a malignant thyroid tumor, preoperatively. There are 5 papillary carcinomas, 1 medullary carcinoma, 1 follicular carcinoma, and 1 fine needle aspiration biopsy proven atypical cell.
RESULTS
Based on preoperative MR imaging, we compared the dynamic MR enhancement pattern relating to the pathologic type. On contrast agent-enhanced dynamic T1-weighted image (T1WI), 5 papillary carcinoma and one medullary carcinoma showed delayed enhancement compared to normal parenchyma. In addition, one follicular carcinoma shows stronger enhancement than normal parenchyma, with one papillary carcinoma showing a persistent decrease in enhancement compared to normal parenchyma.
CONCLUSION
Although this study is limited by a small patients population, the data suggests that delayed enhancement on enhanced dynamic T1WI is a possible characteristic MR finding of a malignant thyroid tumor. I think that the comparison of MR imaging between benign and malignant nodules is required for a correct characterization.

MeSH Terms

Biopsy
Biopsy, Fine-Needle
Carcinoma, Medullary
Carcinoma, Papillary
Humans
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Thyroid Gland

Figure

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  Fig. 1 On ultrasonography, an approximately 8 mm, well define hypoechoic nodule is seen in the mid level of the left lobe of the thyroid gland. This is dynamic images of the thyroid gland in the axial section. The nodule (arrow) was not clearly delineated immediately after contrast injection (as a precontrast scan). Early-phase dynamic images obtained 1 minute 30 seconds after injection best depicts the nodule (arrow) in left thyroid gland. The nodules show decreased enhancment in the early phase of a dynamic enhacement study, compared to normal parenchyma. In addition, the nodule (arrow) shows gradually centrifetal delayed enhancement. A 6-minute image after contrast injection indicates that the nodule is masked into the backgronund thyroid tissue. Note.-FNAB = fine needle aspiration biopsy

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  Fig. 2 On ultrasonography, an approximately 3 centimeter, well defined hyperchoic nodule (white arrow) is seen in right lobe of the thyroid gland at the mid level. On a dynamic image obtained 3 minutes after injection, the nodule (white arrow) shows strong early enhancement compared to the parenchyma of the left lobe. In addition, the nodule (white arrow) shows persistent well enhancement, compared to normal parenchyma. In a 6-minute image after contrast injection, the nodule (white arrow) shows persistent enhancement, but background parenchyma is washed out.

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  Fig. 3 On ultrasonography, an approximately 5 millimeter, well hypoechoic nodule (arrow) is seen in the right lobe of the thyroid gland at mid level. This nodule has internal punctate tiny echogenicity, suggesting a tiny calcification. On a dynamic enhancement study, the nodule (arrow) shows a persistent decrease in enhancement compared to background parenchyma.

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