Multiplanar, bilateral gray scale ultrasound of the thyroid with limited Doppler vascular ultrasound.
Thyroid: The thyroid gland parenchyma is homogeneous. The right lobe is 6.1 x 2.3 x 2.7 cm. The left lobe is 6.2 x 2.1 x 2.0 cm. The isthmus is 7 mm in thickness. There is an ill-defined region in the inferior right thyroid lobe, which may represent an irregular mixed cystic and solid nodule. Subcentimeter hypoechoic to cystic nodules within the left lobe.
Focal Thyroid Observations: (If present and relevant, a maximum of 2 nodules will be described below per TI-RADS recommendations).
Nodule # 1, Size 2.0 cm, inferior right thyroid lobe
COMPOSITION: mixed cystic and solid = 1
ECHOGENICITY: hypoechoic = 2
SHAPE: wider than tall = 0
MARGIN: lobulated/Irregular = 2
ECHOGENIC FOCI (Choose All That Apply):
none or large comet-tail artifacts = 0
Macrocalcifications = No = 0
Peripheral/rim calcifications = No = 0
Punctate echogenic foci = No = 0
ACR TI-RADS risk category: TR4 (4-6 points)
Irregular, ill-defined region in the inferior right thyroid lobe which may represent a mixed cystic and solid nodule with irregular margins, compatible with a TI RADS 4 lesion. Given size greater than 1.5 cm, FNA of this region is suggested.