title: Congenital thyroid hemiagenesis with thyroid nodules-Role of TI-RADS to prevent long term thyroid replacement therapy.
abstract: BACKGROUND
  Hemi-agenesis of thyroid is a rare congenital condition with the clinical significance lying only in cases where the remnant tissue is affected by a pathology mandating removal of the gland. Henceforth, the hemi-thyroidectomy technically becomes a total thyroidectomy with a need for long term thyroid replacement therapy.
  
  
  METHODS
  We present a series of three cases noted over a period of two years where preoperative imaging evaluation confirmed the developmental abnormality. Further presence of a thyroid nodule in each of these cases posed a specific clinical situation whereby characterization of nodule appeared mandatory for a rational management involving life-long thyroid replacement therapy due to an 'apparent total thyroidectomy', if the remnant gland is removed. Ultrasound TI-RADS is a new system for evidence based sub-classification of thyroid nodules enabling both the surgeon and patient to take a streamlined decision about the overall approach for management.
  
  
  CONCLUSIONS
  Prospective nodule characterization based on the thyroid image reporting and data system (TI-RADS), enables the surgeon to decide the treatment strategy sparing the patient of the cost and morbidity associated with long term thyroid replacement therapy.
authors.affiliation: Departments of General Surgery and Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Electronic address: drdnv5@gmail.com.
authors.forename: Ashish
authors.initials: A
authors.lastname: Verma
authors.affiliation: Departments of General Surgery and Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Bhartiya
authors.affiliation: Departments of General Surgery and Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: S P
authors.initials: SP
authors.lastname: Basu
authors.affiliation: Departments of General Surgery and Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: V K
authors.initials: VK
authors.lastname: Shukla
authors.affiliation: Departments of General Surgery and Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Ram C
authors.initials: RC
authors.lastname: Shukla
keywords: CT Angiography; Case series; TI-RADS; Thyroid artery; Thyroid hemiagenesis