Thyroid nodule ultrasound (TIRADS)classification
Please select the characteristics of the nodule:
(Please select at least one option in each category. )
(Please select sequentially in each category for the classification to work properly. )
Notes:
COMPOSITION: If a nodule has spongiform composition, but the spongiform portion is < 50% of the nodular volume, please select mixed cystic and solid nodule.
Mixed cystic and solid nodule has both solid and cystic components. It does not matter which component composes the majority of the nodule.
If the composition of the nodule is indeterminate due to significant calcifications in the nodule, please select SOLID.
If a solid appearing nodule is suspected to be cystic filled with clot or debris, please further evaluate using Doppler.
ECHOGENICITY: Please assign points for echogenicity according to the solid component for mixed cystic and solid nodule. Echogenicity is compared to the adjacent normal thyroid parenchyma. VERY HYPOECHOIC means more hypoechoic than the strap muscles.
SHAPE: Shape should be assessed on a transverse image with measurement parellel to sound beam for height and perpendicular to sound beam for width. This can usually be assessed by visual inspection. Taller-than-wide is a good indicator for potential malignancy.
MARGIN: Lobulated: Protrusions into adjacent normal thyroid tissue. Irregular: jagged, spiculated or sharp angles. Extrathyroidal extension: obvious invasion into tissue surrounding the thyroid, good indication of potential malignancy. Assign 0 point if margin can not be clearly determined.
ECHOGENIC FOCI: Large comet-tail artifact: V shaped, > 1 mm long, common in cystic components. If the comet-tail artifact is < 1 mm, treat it as punctate echogenic foci. Macrocalcifications: Cause acoustic shadowing. If no shadowing, treat it as punctate echogenic foci. Peripheral(rim) calcifications do not have to be complete along the margin. If echogenic foci appear in spongiform nodule, treat the nodule as spongiform nodule.
COMPOSITION: If a nodule has spongiform composition, but the spongiform portion is < 50% of the nodular volume, please select mixed cystic and solid nodule.
Mixed cystic and solid nodule has both solid and cystic components. It does not matter which component composes the majority of the nodule.
If the composition of the nodule is indeterminate due to significant calcifications in the nodule, please select SOLID.
If a solid appearing nodule is suspected to be cystic filled with clot or debris, please further evaluate using Doppler.
ECHOGENICITY: Please assign points for echogenicity according to the solid component for mixed cystic and solid nodule. Echogenicity is compared to the adjacent normal thyroid parenchyma. VERY HYPOECHOIC means more hypoechoic than the strap muscles.
SHAPE: Shape should be assessed on a transverse image with measurement parellel to sound beam for height and perpendicular to sound beam for width. This can usually be assessed by visual inspection. Taller-than-wide is a good indicator for potential malignancy.
MARGIN: Lobulated: Protrusions into adjacent normal thyroid tissue. Irregular: jagged, spiculated or sharp angles. Extrathyroidal extension: obvious invasion into tissue surrounding the thyroid, good indication of potential malignancy. Assign 0 point if margin can not be clearly determined.
ECHOGENIC FOCI: Large comet-tail artifact: V shaped, > 1 mm long, common in cystic components. If the comet-tail artifact is < 1 mm, treat it as punctate echogenic foci. Macrocalcifications: Cause acoustic shadowing. If no shadowing, treat it as punctate echogenic foci. Peripheral(rim) calcifications do not have to be complete along the margin. If echogenic foci appear in spongiform nodule, treat the nodule as spongiform nodule.