الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Thyroid nodules refers to an abnormal growth of thyroid cells that forms a lump within the thyroid gland. Although the vast majority of thyroid nodules are benign (non cancerous), a small percent is presenting as a thyroid cancer. High resolution Thyroid ultrasound (US) is a key examination for the management of thyroid nodules. Thyroid US is easily accessible, non invasive, and cost-effective, and is a mandatory step in the workup of thyroid nodules. The main limitation of this method is that it is operator dependent. Depending on the experience and skills of the examiner. Thyroid US assessment of the risk of malignancy is crucial in patients with nodules, in order to select those who should have a fine needle aspiration (FNA) biopsy performed. In 2017, the Thyroid Imaging Reporting and Data System (TI-RADS) Committee of the American College of Radiology (ACR) published a” white paper” that presented a new risk-stratification system for classifying thyroid nodules on the basis of their appearance at ultrasonography (US). In ACR TI-RADS, points in five feature categories are summed to determine a risk level from TR1 to TR5. Recommendations for biopsy or US follow-up are based on the nodule’s ACR TI-RADS level and its maximum diameter
. The correct interpretation of thyroid ultrasound report using the TI-RADS criteria helps to facilitate the identification of highly suspicious nodules. But not diagnosed them to benign and malignant but to a variable level of risk classifications
Recently the introduction of a new technique as an US examining extension the Elastography with it’s types: strain and shear wave the first one is the more commercially used which can differentiate the malignant and benign nodules using aspecial softwere assessing the tissue elasticity and stiffness both qualititavely as color coding images and semiquatitatively as parameters such as strain ratio
The color coded images are interpreting according to scoring systems of four and five points scales
Finally both the use of TI- RADS and elastography are methods to evaluate thyroids nodules according to US features and scoring systems that they are easy to perform, not invasive, informative, not costly and can be combined together to increase the accuracy of evaluation.