Objective To compare real-time elastography with conventional ultrasonography in diagnosis of thyroid space-occupying nodules. Methods From March 2010 to December 2012, 90 cases with thyroid nodules were examined both conventional ultrasonic imaging and real-time tissue elastography. We combined the two techniques to determine the benign or malignant nodules and then discussed its clinical value. All results were conifrmed by postoperative pathology or ifne-needle aspiration cytology. Elastic sonograms were classiifed into 5 grades (0-VI grade). Results Benign lesions 96, nodular strumous 64, thyroid tumor 25, subacute thyroid inlfammation 7. Malignant lesions 19, papillary carcinoma 13, follicular carcinoma 6. The accuracy, sensitivity and speciifcity of conventional ultrasound diagnosis respectively were 82.6%, 68.4%and 85.4%. Chi-square=3.20, according toα=0.05, P>0.05. The accuracy, sensitivity and speciifcity of ultrasound elastography diagnosis respectively were 86.1%, 73.7%and 88.5%. Chi-square test=2.25, according toα=0.05, P>0.05.Above suggests conventional ultrasonography and elastography technology can on of benign and malignant thyroid nodules occupied it make more accurate judgment. Further application of ultrasonic elastography in accordance with the group judgment in benign and malignant nodule size, nodules diagnosis group compared the sensitivity of the larger nodules group, according to chi-square test=0.046, according to theα=0.05, P<0.05, with signiifcant difference. Conclusion Real-time tissue elastography imaging revealed the basic property of organization’s hardness and combined with conventional ultrasonic inspection could provide more information. This new technology will improve the nodular disease diagnosis.% 目的对比研究实时超声弹性成像技术与常规超声在甲状腺占位性疾病诊断方面的应用。方法2010年3月-2012年12月对90例甲状腺结节患者先后进行常规超声与实时组织弹性成像检查判断甲状腺占位性病灶的良恶性，对两种技术做评价并进一步对占位结节分组，结节大小以2.0 cm为界限分别分析其弹性成像的差异，探讨其临床价值，所有结果均经手术后病理或细针抽吸细胞学证实。实时超声弹性成像技术采用0-VI级评级法对弹性图像评级。结果良性病变共96个，结节性甲状腺肿64个，甲状腺腺瘤25个，亚急性甲状腺炎7个。恶性病变19个，乳头状腺癌13个，滤泡状腺癌6个。常规超声诊断良恶性的准确性82.6%，敏感性68.4%，特异性85.4%，常规超声诊断结节的良恶性的准确性与病理结果对比无显著性差异，χ2检验=3.20，按照α=0.05，P＞0.05；超声弹性成像技术诊断准确性86.1%，敏感性73.7%，特异性88.5%，超声弹性成像诊断结节的良恶性的准确性与病理结果对比无显著性差异χ2检验=2.25，按照α=0.05，P＞0.05；以上提示常规超声与弹性成像技术都能对甲状腺占位结节的良恶性做出较准确的判断。进一步应用超声弹性成像按照结节大小进行分组判断良恶性方面，小结节组诊断的敏感性较大结节组相比，统计数据显示χ2检验=0.046，按照α=0.05， P＜0.05，具有显著性差异。结论实时超声弹性成像技术应用组织硬度判断甲状腺结节良恶性，与常规超声检查的结合为临床提供了更多的组织信息，超声弹性成像对甲状腺小结节占位性病灶良恶性的敏感性更好。
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