Case 4

Male
64
-

Exam Date: 11/10/2023

US: Thyroid gland

ULTRASOUND OF THYROID GLAND
Clinical history: Thyroid nodules
Comparison study: none

FINDINGS

Thyroid size: Rt 3.3×2.7×5.9 cm, isthmus thickness 3.0-mm,Lt 1.2×1.3×4.5 cm, Texture: homogeneous
– Three small subcentrimeter spongioform nodules; two nodules at right lobe and one at isthmus.

Nodule 1

Maximum size: 3.3 cm; Other 2 dimensions 2.7×2.1 cm Location: right, mid
Composition: mixed cystic and solid (1)
Shape: not taller-than-wide (0)
Echogenicity: hypoechoic (2)
Margins : smooth (0)
Echogenic foci: none (0)
ACR TI-RADS total points: 3 ACR TI-RADS risk category: TR3 (3 points)

No cervical lymphadenopathy is noted.

IMPRESSION:

– A3.3×2.7×2.1-cm mixed cystic and solid hypoechoic nodule at right mid thyroid,
TR3 (3 points).
– Three small subcentrimeter spongioform nodules; two nodules at right lobe and one at isthmus.

ACR TI-RADS recommendations
– TR5 (≥7 points) – FNA if ≥ 1cm, follow-up if 0.5 – 0.9 cm every year for 5 years
– TR4 (4-6 points) – FNA fi ≥ 1.5cm, follow-up if 1- 1.4 cm in 1, 2, 3 and 5 years
– TR3 (3 points) – FNA if 2.5cm, follow-up if 1.5 – 2.4 cm in 1, 3 and 5years
– TR2 (2 points) & TR1 (0 points) – No FNA or follow-up