Scribd
Upload
388 views8 pages

TIRADS Classification and Scoring Guide

This document outlines the TIRADS (Thyroid Imaging Reporting and Data System) classification system for thyroid nodules. It describes the categories from TIRADS 1 (normal thyroid) to TIRADS 5 (highly suspicious for cancer). Key aspects include benign features classified as TIRADS 1-2, probably benign features as TIRADS 3, and low to intermediate suspicion features as TIRADS 4A-4B. TIRADS 5 denotes high suspicion and includes nodules with three or more concerning signs such as irregular margins, microcalcifications, or hypoechogenicity. The document also provides a scoring system to classify nodules based on composition,

Uploaded by

Tommy dias r
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
388 views8 pages

TIRADS Classification and Scoring Guide

This document outlines the TIRADS (Thyroid Imaging Reporting and Data System) classification system for thyroid nodules. It describes the categories from TIRADS 1 (normal thyroid) to TIRADS 5 (highly suspicious for cancer). Key aspects include benign features classified as TIRADS 1-2, probably benign features as TIRADS 3, and low to intermediate suspicion features as TIRADS 4A-4B. TIRADS 5 denotes high suspicion and includes nodules with three or more concerning signs such as irregular margins, microcalcifications, or hypoechogenicity. The document also provides a scoring system to classify nodules based on composition,

Uploaded by

Tommy dias r
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
  • TIRADS 1 and 2: Illustrates TIRADS 1 as normal thyroid ultrasound images and TIRADS 2 with benign aspects like simple cysts and spongiform nodules.
  • TIRADS 3: Describes the characteristics of TIRADS 3, focusing on moderately suspicious features such as isoechoic and hyperechoic aspects.
  • TIRADS 4A: Highlights the features of TIRADS 4A with low suspicion findings, detailing mild hypoechogenicity.
  • TIRADS 4B: Examines TIRADS 4B, characterized by intermediate suspicious features, including taller-than-wide shapes and irregular margins.
  • TIRADS 5: Details TIRADS 5 with highly suspicious ultrasound features, including marked hypoechogenicity and microcalcifications.
  • Scoring and Classification Criteria: Explains the scoring criteria for TIRADS, assigning points based on composition, echogenicity, shape, margin, and echogenic foci.
  • Scoring and Classification Guidelines: Outlines classification guidelines, linking TIRADS scores to follow-up recommendations for thyroid nodules.
  • Ultrasound Images: Provides additional ultrasound images for reference, showcasing various thyroid nodule appearances.

TIRADS 1

Normal Thyroid

BENIGN ASPECTS
 Simple cyst
 Spongiform nodule
 ‘White knight’ aspect TIRADS 2
 Isolated macrocalcification
 Typical subaute thyroiditis
PROBABLY BINAGN ASPECT
 None of the hight suspicious
aspect
 Isoechogenic TIRADS 3
 Hyperechogenic
LOW SUSPICIOUS ASPECT
 None of the higt suspicious TIRADS 4A
suspect
 Moderately hypoechogenic
Intermediate suspicion
1 or 2 sign and no adenopathy:
 Taller-than-wide shape
 Irregular or microlobulated TIRADS 4B
margins
 Microcalcifications
 Marked hypoechogenicity
TIRADS 4B
Moderate Suspicion

Intermediate suspicion
≥3 signs and / or adenopathy:
 Taller-than-wide shape
 Irregular or microlobulated TIRADS 5
margins
 Microcalcifications
 Marked hypoechogenicity
One score is assigned from each of the following categories: Points

Composition: (choose one)

o Cystic or completely cystic 0


o Spongiform 0
o Mixed cystic and solid 1
o Solid or almost completely solid 2

Echogenicity: (choose one)

o Anechoic 0
o Hyper- or isoechoic 1
o Hypoechoic 2
o Very hypoechoic 3

Shape: (choose one) (assessed on the transverse plane)

o Wider than tall 0


o Taller than wide 3

Margin: (choose one)

o Smooth 0
o Ill-defined 0
o Lobulated/irregular 2
o Extra-thyroidal extension 3

*Any and all findings in the final category are also added to the other
four scores.
echogenic foci: (choose one or more)

o none 0
o large comet-tail artifact 0
o macrocalcifications 1
o peripheral/rim calcifications 2
o punctate echogenic foci 3
Scoring and classification

 TR1: 0 points
o benign  No FNA
 TR2: 2 points
o not suspicious  No FNA
 TR3: 3 points
o mildly suspicious  FNA if ≥2,5 cm, Follow up if ≥1,5 cm
 TR4: 4-6 points
o moderately suspicious  FNA if ≥1,5 cm, Follow up if ≥ 1,0 cm
 TR5: ≥7 points
o highly suspicious  FNA if ≥1,0 cm, Follow up if ≥0.5 cm

BENIGN ASPECTS Simple cyst Spongiform nodule ‘White knight’ aspect Isolated macrocalcification Typical subaute thyroidit
PROBABLY BINAGN ASPECT None of the hight suspicious aspect Isoechogenic Hyperechogenic TIRADS 3
LOW SUSPICIOUS ASPECT None of the higt suspicious suspect Moderately hypoechogenic TIRADS 4A
Intermediate suspicion 1 or 2 sign and no adenopathy: Taller-than-wide shape Irregular or microlobulated margins Microcal
Intermediate suspicion ≥3 signs and / or adenopathy: Taller-than-wide shape Irregular or microlobulated margins Microcalc
One score is assigned from each of the following categories: Points Composition: (choose one) o Cystic or completely cystic o
Scoring and classification  TR1: 0 points o benign  No FNA  TR2: 2 points o not suspicious  No FNA  TR3: 3 points o mi

You might also like