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Purpose: To investigate the diagnostic performance of Color Doppler Flow Imaging (CFI) vascularity score in comparison to the ACR TI-RADS for prediction of malignancy in thyroid nodules (TNs). Materials and Methods: A cross-sectional prospective study design was used. Patients underwent thyroid ultrasound imaging for TNs which classified the TNs using ACR TI-RADS and CFI vascularity score. Receiver operating characteristic (ROC) analysis was applied to compare between the CFI vascularity score and ACR TI-RADS. Results:A total of 222 patients participated in this study, 76.6% of them were female, with a mean age of 44.73 ± 13.31 years (range, 18 to 85). Ultrasound imaging classified TNs as: (TI-RADS 4= 41%), (TI-RADS 5=30.6%), and (TI-RADS 3= 28.4%). TNs of TIRADS 3, 4, and 5 and with CFI vascularity score category 1 were100% benign, and TNs of TIRADS 3, 4, and 5 and with CFI vascularity score category 4 were malignant in 82.5%, 91.3%, 100%, respectively, (p2. However, the ACR TI-RADS showed sensitivity 57.4%, specificity 94.7%, PPV 91.2% and NPV 70.1% in prediction malignancy, in ACR TI-RADS ≥ 4, (pConclusion:Combining CFI vascularity score and TI-RADS can be consider as a safe and non-invasive diagnostic method for accurate risk stratification of TNs and can resolve the gap in follicular TNs.

Hydatid cyst is a common name for the larval stage of a tapeworm species of Echinococcus granulosus, which is transmitted from animals to humans via the fecal–oral route. Hydatid cysts predominantly affect the liver (75%), followed by the lung (15%), and they can affect many organs in the human body. Medical imaging modalities are the keystone for the diagnosis of hydatid cysts with high sensitivity and specificity. Ultrasound imaging with high resolution is the first choice for diagnosis, differential diagnosis, staging, establishing a role in interventional management, and follow-up, and it can differentiate Type I hydatid cysts from simple liver cysts. Unenhanced computed tomography (CT) is indicated where or when an ultrasound is unsatisfactory, such as with chest or brain hydatid cysts, when detecting calcification, and in obese patients. Magnetic resonance imaging (MRI) is superior for demonstrating cyst wall defects, biliary communication, neural involvement, and differentiating hydatid cysts from simple cysts using diffusion-weighted imaging (DWI) sequences. According to the phase of growth, hydatid cysts occur in different sizes and shapes, which may mimic benign or malignant neoplasms and may create diagnostic challenges in some cases. Hydatid cysts can mimic simple cysts, choledochal cysts, Caroli’s disease, or mesenchymal hamartomas of the liver. They can mimic lung cystic lesions, mycetoma, blood clots, Rasmussen aneurysms, and even lung carcinomas. Differential diagnosis can be difficult for arachnoid cysts, porencephalic cysts, pyogenic abscesses, and even cystic tumors of the brain, and can create diagnostic dilemmas in the musculoskeletal system.

Tuberculosis (TB) is a bacterial infection with Mycobacterium tuberculosis; it is a public health problem worldwide and one of the leading causes of mortality. Since December 2019, the COVID-19 pandemic has created unprecedented health challenges and disrupted the TB health services, especially in high-burden countries with ever-increasing prevalence. Extrapulmonary and even pulmonary TB are an important cause of nonspecific clinical and radiological manifestations and can masquerade as any benign or malignant medical case, thus causing disastrous conditions and diagnostic dilemmas. Clinical manifestations and routine laboratory tests have limitations in directing physicians to diagnose TB. Medical-imaging examinations play an essential role in detecting tissue abnormalities and early suspecting diagnosis of TB in different organs. Radiologists and physicians should be familiar with and aware of the radiological manifestations of TB to contribute to the early suspicion and diagnosis of TB. The purpose of this article is to illustrate the common radiologic patterns of pulmonary and extrapulmonary TB. This article will be beneficial for radiologists, medical students, chest physicians, and infectious-disease doctors who are interested in the diagnosis of TB.