COLOR-CODED DUPLEX SONOGRAPHY AND CONTRAS T-ENHANCED MRT OF SCINTIGRAPHICALLY COLD THYROID-NODULES

In order to establish diagnostic criteria, colour coded duplex sonogra phy was performed on 40 patients who had a total of 43 operatively con firmed thyroid lesions which were scintigraphically ''cold'' (28 adeno mas, 8 carcinomas, 4 cases of thyroiditis and 3 cysts). 32 of these pa tients also had MRT with T-2- and T-1-weighted images before and after injection of Gd-DTPA (0.1 mmol/kg). Adenomatous nodules and adenomas showed a peripheral vascular halo on colour coded duplex sonography wi th a sensitivity of 96% and a specificity of 93%. Malignant lesions sh owed marked central vascularisation and on B-images irregular marginal structures. Adenomas and adenomatous nodules showed hyperintense area s on T-1-weighted unenhanced MR images and/or homogenous uptake in the lesion (sensitivity 100%, specificity 77%). Malignant lesions typical ly showed an irregular margin with increased contrast uptake on MRT. I f sonography and colour coded duplex sonography is unable to classify a lesion with any degree of assurance then MRT with Gd-DTPA enhancemen t should be performed.