How to Read a Thyroid Ultrasound Report

How to Read a Thyroid Ultrasound Report | UCLA Endocrine Center

Hi, I'm James Wu, an endocrine surgeon at UCLA. Today I want to talk to you about how to make sense of your ultrasound report.

Of course, the best thing to do is talk to your doctor who ordered the test. When doctors order an ultrasound to look at the thyroid gland, we are checking to see if the thyroid is a normal size or if the thyroid gland has thyroid nodules growing inside.

First, the report will say how big the thyroid gland is. It will report how long, how wide, and how deep the thyroid is. People of different sizes will have different thyroid glands with different sizes. If the thyroid gland is bigger than it should be, the radiologist may call it a goiter. When we notice that you have a goiter, we will also know whether it goes behind the collarbone or breastbone or not. When it does, it's called a substernal goiter.

Second, the report will also say no thyroid nodules are present or there are a certain number of thyroid nodules present. When thyroid nodules are seen, we check them carefully to assess the risk of cancer. We look to see whether the nodule is solid or mostly liquid, whether it's round or abnormally shaped, and whether there are small specks of calcium in the nodule or not. All these factors are added to a score called a TIRAD score. TIRAD stands for Thyroid Imaging Reporting and Data System. Low scores like TIRADS 1 mean that the nodule appears very benign and does not need more testing. High scores (TIRADS 5 is the highest) mean that there is a high chance of the nodule being cancerous. Those nodules should be biopsied to check for thyroid cancer.

In addition to the TIRAD system, the American Thyroid Association also has an ultrasound scoring system that some like to use. In some reports, nodules will be labeled as ATA high risk, intermediate risk, low risk, or very low risk.

So to sum up, the best thing to do is discuss your ultrasound findings with your doctor who ordered the test. You can look to see whether the report says goiter or not to know if your thyroid is enlarged for your body. You can also look to see if any thyroid nodules are seen and if they are, what the risk of cancer may be in each nodule. Nodules that are high risk should be evaluated by an endocrinologist or endocrine surgeon for possible testing and workup.

If you would like more information, please call us for consultation.


  • The size of the thyroid gland is crucial in determining its normal or enlarged state, which helps diagnose a goiter.
  • Assessing thyroid nodules involves evaluating their solidity, shape, and presence of calcium specks, which aids in determining their risk of cancer.
  • Tie Rad scores and the American Thyroid Association's ultrasound scoring system provide standardized methods to categorize nodules based on their risk levels.
  • Discussing the ultrasound findings with the doctor who ordered the test is essential for a comprehensive understanding of the report.
  • Identifying high-risk nodules is crucial, as they require further evaluation by specialists for potential testing and treatment.
  • Regular follow-up with healthcare professionals and seeking consultation is vital for accurate diagnosis and appropriate management.
  • The UCLA Endocrine Center website provides additional information and resources for those seeking further guidance on thyroid ultrasound reports.

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