Abstract
Background: The purpose of this study was to evaluate the clinical significance of thyroid incidentaloma with hypersignal intensity on the time of flight magnetic resonance (TOF-MR) angiography and correlation with ultrasound (US).Methods: We retrospectively reviewed 3,505 non-contrast TOF-MR angiography performed at our institution between September 2014 and May 2017. Two radiologists correlated the thyroid incidentalomas detected on TOF-MR angiography with US features that were obtained within a three-month interval between MR and US examinations in consensus.Results: The prevalence of hyperintense thyroid nodules incidentally detected by TOF-MR angiography was 1.2% (43/3,505 patients). Among these, 35 people (77.8%) underwent US examinations, and a total of 45 hyperintense thyroid nodules were detected by US studies. Of these 45 nodules, more than 70% were categorized as benign on US exams. Fine needle aspiration was performed on nine nodules according to indications recommended by the Korean Society of Thyroid Radiology. All except one high-suspicion thyroid nodule were confirmed as benign (Bethesda 2) on cytologic examination. The high-suspicion nodule on US showed a nondiagnostic result (Bethesda 1). However, this nodule collapsed after aspiration of thick colloid.Conclusions: Our study demonstrated that the most hyperintense thyroid nodules detected on TOF-MR angiography were benign. Therefore, if a hyperintense incidentaloma is found on TOF-MR angiography, the thyroid nodule is more likely to be benign. We believe that these findings could offer additional information for further clinical management.
Highlights
A total of 54 thyroid incidentalomas were detected on unenhanced time of flight magnetic resonance (TOF-MR) angiography as focal hyperintensities in 43 people (17 men, 26 women; mean ± SD age, 59.4 ± 9.3 years; range, 31–76 years) among the 3,505 individuals who underwent Time of flight (TOF)-MR angiography
When rapidly applied radiofrequency pulses are repeated at a region, stationary spins in that region cannot relax between pulses, and any background signal arising from these stationary spins degrades TOF data, eventually resulting in effective suppression of background signals except moving spins newly entering the section, such as blood
We reviewed more than 3,500 examples of MR data, we found only 45 thyroid nodules because of the very low prevalence of thyroid incidentalomas on TOF-MR angiography
Summary
An autopsy study of 821 consecutive patients with clinically normal thyroid glands found the prevalence of thyroid nodules to be greater than 50% [1]. Prospective studies in the general population show a high prevalence of small thyroid nodules measuring
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