Evaluation of the Relationship Between Resistive Index, Elastographic Stiffness, and TIRADS Category in Thyroid Nodules

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Deniz Esin Tekcan Şanlı, Bilal Turan

Volume 9 · Issue 1 · pp. 109–114

Received: 20251212  Accepted: 20260217  Published: 20260317

Abstract

Objective:To investigate the relationship between Doppler-derived resistive index(RI) values, TI-RADS categories, and shear-wave elastography(SWE) parameters in solid thyroid nodules, and to determine whether RI contributes additional value to imaging-based characterization.Material-Methods:This retrospective study included 52 patients with 52 solid thyroid nodules larger than 1 cm. All nodules were evaluated with grayscale ultrasonography, Doppler sonography, and SWE. TI-RADS categories were assigned according to standard B-mode criteria. Vascularity was classified into four Doppler patterns, and RI was measured from intranodular arterial flow in nodules exhibiting pattern 2 or 3 vascularization. SWE measurements included mean shear-wave velocity(Vmean) and velocity standard deviation(Vsd). Associations between RI and demographic(age,sex), morphologic(nodule size,TI-RADS),and elastographic(Vmean,Vsd) variables were analyzed using correlation and nonparametric tests. Histopathology was available only in a limited subgroup and was therefore not used as a primary endpoint.Results:The mean age was 49.28±14.55 years; 88.5% of patients were male. TI-RADS categories were TI-RADS 2 in 19 nodules(36.5%), TI-RADS 3 in 29 nodules(55.8%), and TI-RADS 4 in 4 nodules(7.7%). Mean nodule diameter was 17.06±6.63 mm. Vmean and Vsd were 2.47±0.86 m/s and 0.62±0.39 m/s, respectively. Mean RI was 0.52±0.14. RI showed no significant association with age, sex, nodule side, size, Vmean, or Vsd. Although RI values were slightly higher in TI-RADS≥3 nodules compared to lower TI-RADS categories, this difference was not statistically significant(p=0.054).Conclusion:In this preliminary cohort, RI was not significantly associated with TI-RADS classification or SWE-derived stiffness parameters. These findings suggest that RI offers limited additional diagnostic value beyond conventional ultrasonography and elastography in the structural evaluation of thyroid nodules.

Keywords: Shear wave elastography; resistive index; TIRADS; Doppler sonography

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Cite this article

Deniz Esin Tekcan Şanlı, Bilal Turan. Evaluation of the Relationship Between Resistive Index, Elastographic Stiffness, and TIRADS Category in Thyroid Nodules. Journal of Cukurova Anesthesia and Surgical Sciences. 9(1):109-114. https://doi.org/10.36516/jocass.1841024

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