TIRADS US Score

Infographic explaining ACR TI-RADS thyroid ultrasound criteria including composition echogenicity margins shape calcifications and scoring for malignancy risk

The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) is a standardized ultrasound-based risk stratification framework for thyroid nodules. It assigns points across five sonographic domains—composition, echogenicity, shape, margins, and echogenic foci—each reflecting increasing probability of malignancy.

The cumulative score categorizes nodules from TR1 (benign) to TR5 (highly suspicious), with defined thresholds guiding fine-needle aspiration (FNA) and surveillance. This structured approach reduces interobserver variability, improves reporting consistency, and aligns intervention decisions with malignancy risk rather than size alone.

References
Pires AT, Mustafá AMM, Magalhães MOG. The 2017 ACR TI-RADS: pictorial essay. Radiol Bras. 2022 Jan-Feb;55(1):47-53. doi: 10.1590/0100-3984.2020.0141. PMID: 35210664; PMCID: PMC8864691.

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