Objective  This study aims to evaluate ultrasound imaging and ultrasound elastography of benign and malignant thyroid nodules in the differential diagnosis.

  Methods  A total of 164 benign and malignant thyroid nodules confirmed using pathology, ultrasound contrast, and elasticity imaging characteristics were analyzed to assess the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate.

  Results  The 164 thyroid nodules included 96 benign lesions and 68 malignant lesions.After the injection of contrast medium, the benign nodules enhanced the surrounding glands later than the peripheral gland dissection.Majority of the nodules exhibited peripheral ring enhancement.The malignant nodules were mostly low-enhanced and uneven enhanced echo as early as the dissipation of the surrounding thyroid tissue.The contrast sensitivity, specificity, positive predictive value, and negative predictive values of ultrasound were 91.18%, 93.75%, 91.18%, and 93.75%, respectively.The sensitivity, specificity, positive predictive value, and negative predictive values of elastrography were 88.24%, 91.67%, 88.24%, and 91.67%, respectively. The contrast sensitivity, specificity, positive predictive value, and negative predictive values of ultrosound combined with elastography were 97.06%, 85.42%, 82.50%, and 97.62%, respectively.

  Conclusion  Ultrasound imaging and elastography have a high value for differential diagnosis of benign and malignant thyroid nodules, and the combination of the two methods can improve the diagnosis rate.