![]() ![]() The above systems were difficult to apply clinically due to their complexity, leading Kwak et al. TUS 5: consider surgery regardless of fine needle aspiration biopsy result.TUS 4: fine needle aspiration biopsy and immediate reaspiration if nondiagnostic cytological result.TUS 3: fine needle aspiration biopsy and short term (6 month) follow up if nondiagnostic cytological result.TUS 2: long term ultrasound follow up if clinically needed.TUS 1: no additional ultrasound is recommended if clinically not needed.Each variable is valued at 1 for the presence of the following and 0 otherwise: The probability of malignancy was based on an equation derived from 12 features 2. TUS 5: high suggestive of malignancy (91-100% malignancy).TUS 4: probably malignancy (51-90% malignancy).TUS 3: indeterminate (24-50% malignancy).TUS 2: probably benign (8-23% malignancy).TUS 1: highly suggestive of benign (0-7% risk of malignancy).The risk of malignancy was derived from thyroid ultrasound (TUS) features. proposed a system with five categories, which, like BI-RADS, each carried a management recommendation 2. The authors stated that TI-RADS 4 and 5 nodules must be biopsied. malignancy pattern C: mixed echogenicity or isoechoic without hyperechoic spots, nonencapsulated, hypervascularised.malignant pattern B: isoechoic or hypoechoic, nonencapsulated, hypervascularised, multiple peripheral microcalcifications.malignant pattern A: hypoechoic, nonencapsulated with irregular margins, penetrating vessels.suspicious neoplastic pattern: hyperechoic, isoechoic, or hypoechoic encapsulated with a thick capsule hypervascularised with calcifications (coarse or microcalcifications). ![]() de Quervain pattern: hypoechoic, ill-defined borders, without calcifications.simple neoplastic pattern: solid or mixed hyperechoic, isoechoic, or hypoechoic encapsulated with a thin capsule.Hashimoto pseudonodule: hyperechoic, isoechoic, or hypoechoic partially encapsulated peripheral vascularity in the setting of Hashimoto thyroiditis.colloid type 3: mixed echogenicity or isoechoic with hyperechoic spots and solid portion, expansile, nonencapsulated, vascularized.colloid type 2: mixed echogenicity with hyperechoic spots, nonexpansile, nonencapsulated, vascularized, spongiform/"grid" aspect.colloid type 1: anechoic with hyperechoic spots, nonvascularised.Thyroid nodules could be classified into one of 10 ultrasound patterns, which had a corresponding TI-RADS category. TI-RADS 3: probably benign nodules (80% malignancy).TI-RADS 2: benign conditions (0% risk of malignancy).The system has fair interobserver agreement 4. A TI-RADS was first proposed by Horvath et al. in 2009 1. ![]()
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