TIRADS Calculator for Thyroid Nodules
Spongiform: Composed predominantly (>50%) of small cystic spaces. No further points are added for other categories.
Mixed cystic and solid: Assign points for predominant solid component.
Anechoic: Applies to cystic or almost completely cystic nodules.
Hyperechoic/isoechoic/hypoechoic: Compared to adjacent parenchyma.
Very hypoechoic: More hypoechoic than strap muscles.
Shape should be assessed on a transverse image with measurements parallel to sound beam for height and perpendicular to sound beam for width.
Lobulated: Protrusions into adjacent parenchyma.
Irregular: Jagged, spiculated, or sharp angles.
Extrathyroidal extension: Obvious invasion of adjacent soft tissue or vascular structures.
Large comet-tail artifacts: V-shaped, >1 mm, in cystic components.
Macrocalcifications: Cause acoustic shadowing.
Peripheral calcifications: Complete or incomplete along margin.
Punctate echogenic foci: Nonshadowing, may have small comet-tail artifacts.