Lim Hyun Kyung, Park Sung Tae, Ha Hongil, Choi Seo-youn
Department of Radiology, Section of Neuroradiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea.
Department of Radiology, Hallym University Medical Center, Hallym University Sacred Heart Hospital, Anyang, South Korea.
PLoS One. 2016 Feb 26;11(2):e0149811. doi: 10.1371/journal.pone.0149811. eCollection 2016.
Incidental thyroid lesions are frequently found on contrast-enhanced magnetic resonance (CE-MR) angiography. The purpose of this study is to determine the prevalence of thyroid incidentalomas detected by CE-MR angiography and to evaluate their clinical significance by correlation with ultrasound (US) and cytopathological results.
We retrospectively reviewed 3,299 consecutive CE-MR angiography examinations performed at our institution between January 2010 and March 2013. Two radiologists evaluated the CE-MR angiography imaging in consensus regarding the presence, location, and vascularity of thyroid incidentaloma. We correlated these findings with follow-up US and cytopathologic results.
The prevalence of thyroid incidentalomas detected by CE-MR angiography was 4.6% (152/3,299 patients). CE-MR angiography showed hypervascularity in 86.8% (145/167), isovascularity in 8.4% (14/167), and hypovascularity in 4.8% (8/167) of thyroid nodules compared to vascularity of thyroid parenchyma. Among the patients with thyroid incidentaloma, 34 patients (22.4%) were followed by US examination, and all 36 nodules on CE-MR angiography were detected on follow-up US. Of these nodules, 9 (25%) nodules were classified as probably benign, 26 (72.2%) as indeterminate, and 1 (2.8%) as suspicious malignant nodule. Among the 16 nodules with available cytopathologic results, 12 nodules were benign, 2 nodules were follicular neoplasm, and 2 nodules showed non-diagnostic results.
Incidental thyroid nodules were found in 4.6% of CE-MR angiography examinations. Because the high incidence of indeterminate US feature among thyroid incidentaloma, when a thyroid incidentaloma is detected on CE-MR angiography, further evaluation with US should be performed.
在对比增强磁共振（CE-MR）血管造影中经常发现甲状腺意外瘤。本研究的目的是确定CE-MR血管造影检测到的甲状腺意外瘤的患病率，并通过与超声（US）和细胞病理学结果相关联来评估其临床意义。
我们回顾性分析了2010年1月至2013年3月在我院连续进行的3299例CE-MR血管造影检查。两名放射科医生就甲状腺意外瘤的存在、位置和血管情况达成共识，对CE-MR血管造影图像进行评估。我们将这些结果与后续的超声和细胞病理学结果相关联。
CE-MR血管造影检测到的甲状腺意外瘤患病率为4.6%（152/3299例患者）。与甲状腺实质血管相比，CE-MR血管造影显示86.8%（145/167）的甲状腺结节为高血管性，8.4%（14/167）为等血管性，4.8%（8/167）为低血管性。在患有甲状腺意外瘤的患者中，34例患者（22.4%）接受了超声检查，CE-MR血管造影上的所有36个结节在后续超声检查中均被检测到。在这些结节中，9个（25%）结节被分类为可能良性，26个（72.2%）为不确定，1个（2.8%）为可疑恶性结节。在16个有可用细胞病理学结果的结节中，12个结节为良性，2个结节为滤泡性肿瘤，2个结节显示非诊断性结果。
在4.6%的CE-MR血管造影检查中发现了甲状腺意外结节。由于甲状腺意外瘤中超声特征不确定的发生率较高，当在CE-MR血管造影中检测到甲状腺意外瘤时，应进行超声进一步评估。
