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

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.

The Value of Additional Cervicothoracic Spine Sagittal T2-weighted Images Included in Routine Lumbar Spine MR Imaging

PURPOSE: To evaluate the usefulness of cervicothoracic spine sagittal T2-weighted images (CT SAG T2WIs) included in routine lumbar spine MRI. MATERIALS AND METHODS: Institutional review board approval was obtained and informed consents were waived for this retrospective study. The study group comprised 2,113 patients who underwent lumbar spine MRI from January 2005 to December 2005. CT SAG T2WIs were added in the routine lumbar spine MRIs. Radiologic reports were reviewed retrospectively for pathologic lesions on CT SAG T2WIs by one radiologist. Information of additional cervical or thoracic spine MRI and/or CT for further evaluation of positive findings on CT SAG T2WIs and their treatment were collected by retrospectively reviewing medical records. RESULTS: The CT SAG T2WIs revealed 142 pathologic lesions in 139 (6.58%) of the 2,113 patients. They were easily obtained without positional change in a scan time of less than 2 minutes. Additional cervical or thoracic spine MRI and/or CT for positive findings on CT SAG T2WIs were performed in 13 patients. Seven patients underwent surgical treatment. CONCLUSION: CT SAG T2WIs included in routine lumbar spine MRI were useful in finding the pathologic lesions in cervicothoracic spine for the patients who assumed to have lesions in lumbar spine.