Head and neck, Thyroid / Parathyroids, Ultrasound, Diagnostic procedure, Calcifications / Calculi, Cysts, Neoplasia
M. Mohandas, S. Nadarajan, N. Hubert, L. Jose; Thiruvananthapuram/IN
- When TIRADS 2 & 3 are considered benign and TIRADS 4A,
4B & 5 are considered malignant,
TIRADS score had high negative predictive value (98.5%).
if a nodule was assigned a benign score of TIRADS 2/3,
it is highly unlikely to be malignant,
thus helping to avoid unnecessary FNAs and / or surgical excision.
- All nodules assigned as TIRADS 2 (benign) turned out to be benign.
- As the TIRADS score increases,
the risk of malignancy increases.
- As echogenicity decreases,
risk of malignancy increases.
- High specificity for detecting malignancy were noted for marked hypoechogenicity (94.8%),
taller than wide shape (98.7%),
irregular margin (97.4%) and presence of microcalcification (97.9%).
Among these sonographic features,
highest specificity was noted for taller than wide shape (98.7%).
- Statistically significant association was noted for the following parameters in detecting malignancy: moderate and marked hypoechogenicity,
taller than wide shape,
presence of microcalcification and lymph node without fatty hilum.
- Inspissated colloid can mimic microcalcification which can influence the diagnostic performance of TIRADS.
- On retrospective comparison of final pathological diagnosis with the assigned TIRADS score,
it was found that majority of benign nodules were assigned benign TIRADS (2 & 3) and all malignancies except 1 were assigned malignant TIRADS score (4A,
4B & 5).
it is possible to assign benign status to nodules with good reliability,
thereby avoiding unnecessary FNAs.
TIRADS is also helpful to detect most thyroid malignancies and to guide management decisions.