Recent Advances of TIRADS Classification of Thyroid Nodules by Ultrasound

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Background Thyroid nodules are abnormal growths of thyroid tissue which commonly arise within an otherwise normal thyroid gland. They may be hyperplasia or a thyroid neoplasm, but only a small percentage of the latter are thyroid cancers. Small, asymptomatic nodules are common, and many people who have them are unaware of them. Thyroid nodules can be felt as a lump in the throat. When they are large, they can sometimes be seen as a lump in the front of the neck. Objectives The aim of this work was to improve the management of the patients and to reduce cost-effectiveness by decreasing number of unnecessary fine needle aspiration cytology (FNAC). Patients and Methods This study was conducted on 50 patients with thyroid nodules detected by clinical palpation or incidentally noted during neck imaging for other reasons. There were 33females (74%) and 17 males (26%). Their ages ranged from 41 to 50 years. All patients in the study were subjected to full history taking, thorough clinical examination. Gray scale Ultrasound and color Doppler examination were done to all patients. The nodules were classified into TIRADS categories and the risk of malignancy was calculated for each category. Results All the nodules with TIRADS 1 were benign. In TIRADS 2 there were 10 benign and 1 malignant nodules. In TIRADS 3 there were 4 benign and 1 malignant nodules. In TIRADS 4 there were 2 benign nodules and 4 benign nodules while in TIRADS 5 there were 2 benign and 4 malignant nodules. There was a statistically significant difference between the two groups. There was a statistically significant difference between the two groups with benign and malignant nodules regarding the texture of the nodules. Solid texture was higher in the malignant nodules and spongiform texture was common in the benign nodules while the cystic and mixed texture were comparable between the two groups. Hypoechoic nodules were higher in the malignant nodules, however, there was no statistically significant difference between the two groups with benign and malignant nodules regarding the echogenicity of the nodules. There was a statistically significant difference between the two groups with benign and malignant nodules regarding the echogenic foci. Conclusion The major ultrasound features seen associated with malignancy were microcalcifications, taller than wider shape of the nodule, hypoechoic and marked hypoechoic echopattern of the nodule, irregular borders and presence of suspicious cervical lymph nodes.