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Optimal treatment of thyroid cancer is highly dependent on accurate staging of the extent of disease at presentation. Preoperative ultrasonography (US) is the most sensitive method for detecting metastatic lymph nodes and is recommended as part of the standard preoperative workup. Missed findings on preoperative scans may lead to understaging and inadequate surgical management, which subsequently predispose these patients to residual disease postoperatively and a higher risk for recurrence, possibly requiring repeat surgery. Traditionally, thyroid US for pre- and postoperative staging has been performed by radiologists. However, there is a growing trend away from radiologist-performed US in favor of surgeon-performed US. Recent surgical and endocrinology literature has shown that, when compared with surgeon-performed US, radiologist-performed preoperative staging US is less accurate and is inadequate for presurgical planning, with higher local recurrence rates. This review highlights the importance of accurate preoperative US for patients with differentiated thyroid cancer, with specific attention to deficiencies that exist in general radiology department thyroid US reports. We present a standardized approach to neck US reporting that incorporates the newly updated 2015 recommendations from the American Thyroid Association and also addresses the pertinent questions for thyroid surgeons. By ensuring comprehensive preoperative assessment and improving thyroid US reporting, we seek to improve patient access to optimized care. RSNA, 2016.

ADC values derived from the diffusion sequence have significantly lower values in renal abscesses than in areas of nephritis.

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Background:Haemangioma (HM) and venous malformations of the head and neck are formidable lesions as they cause cosmetic deformity and psychological problems. Their surgical excision is difficult and fraught with problems like operative blood loss, incomplete excision, disfigurement and recurrence. Endovascular techniques like sclerotherapy and embolization are increasingly being used in the treatment of these difficult lesions.Objectives:This study was undertaken to analyse the efficacy and safety of endovascular techniques in the treatment of HM and slow flow vascular malformations.Materials and Methods:We retrospectively reviewed the records and clinical photographs of 358 patients of HM and slow flow vascular malformations treated in our institute by endovascular approach over a 15 year period. Pre- and post-treatment photographs were compared and outcomes categorized as complete resolution (>90% reduction), considerable reduction (60-90% reduction), partial reduction (20-60% reduction) and no change (<20% reduction).Results:Complete resolution of the lesion was seen in 30% of the patients while 50% patients showed considerable reduction of the swelling. Complications occurred in 6.4% of patients.Conclusion:We conclude that sclerotherapy is an effective and safe treatment modality for these lesions and may be considered as the primary modality in the treatment of these challenging lesions.

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A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. A left C2 root tie-off, targeted epidural blood patch, and Dura seal glue resulted in resolution of patient symptomatology highlighting the importance of fused SPECT/CT images in detection of an occult cerebral spinal fluid leak.