Abstract: Objective To explore the differential diagnostic value of real-time ultrasound elastography (USE) on single solid thyroid nodules (≤15 mm in maximum diameter) which are difficult to diagnose with conventional ultrasound.Methods A total of 82 patients with small single solid thyroid nodules were performed with two-dimensional and color Doppler ultrasound. Each patient was then examined by real-time USE, and the findings on elastography were classified into grade Ⅰ-Ⅴ. Ultrasonographic results were compared with histopathologic data.Results Twelve patients were found with benign lesion ranging from grade Ⅰ to Ⅱ, thirteen patients were found with grade Ⅲ (5 benign and 8 carcinoma); fifty-seven patients were found with grade Ⅳ and Ⅴ (3 benign and 54 carcinoma). Small solid thyroid nodules with grade Ⅳ and Ⅴ were diagnosed as thyroid cancer with the specificity 85.0%, sensitivity 87.1%, and accuracy 86.6%. The positive and negative predictive values were 94.7% and 68.0%.Conclusion Real-time USE seems to have great value for differential diagnosis of small single solid thyroid nodules ≤15 mm in maximum diameter than conventional ultrasound.

Key words: thyroid nodule, ultrasonography, elastography