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目的:探究超声弹性成像联合超声造影对甲状腺实性低回声结节良恶性的诊断价值。方法:选择2018年5月至2020年5月于濮阳市妇幼保健院经常规超声检查表现为甲状腺实性低回声结节且拟行外科手术切除甲状腺结节的患者82例,共103个结节,术前均进行超声弹性成像、超声造影检查,以术后病理诊断结果为金标准,评价不同超声检查及超声弹性成像联合超声造影对结节良恶性的诊断效能。结果:82例患者103个甲状腺结节中,经术后组织病理学检查确诊恶性结节62个、良性结节41个,常规超声、超声弹性成像、超声造影单独诊断检出恶性结节分别为63、60、61个,良性结节分别为40、43、42个,超声弹性成像联合超声造影诊断检出恶性结节59个,良性结节44个。超声弹性成像联合超声造影诊断甲状腺实性低回声结节的诊断效能均高于其单独超声检查,诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为91.94%、95.12%、93.20%、96.61%、88.64%。结论:超声弹性成像联合超声造影在甲状腺实性低回声结节良恶性诊断中具有较高诊断效能,有助于指导临床诊疗。“,”Objective:To investigate the diagnostic value of ultrasound elastography combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant solid hypoechoic thyroid nodules.Methods:A total of 82 patients (103 nodules) with solid hypoechoic thyroid nodules who were diagnosed by routine ultrasound examination, and planned to undergo surgical resection of thyroid nodules in Puyang Maternal and Child Health Hospital from May 2018 to May 2020 were selected. All patients underwent ultrasound elastography and contrast-enhanced ultrasound before surgery. Taking postoperative pathological diagnosis results as the gold standard, the efficacy of different ultrasound examinations, and ultrasound elastography combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant nodules was evaluated.Results:Among 103 thyroid nodules in 82 patients, 62 malignant nodules and 41 benign nodules were confirmed by histopathological examination. And 63, 60 and 61 malignant nodules were detected by conventional ultrasound, ultrasonic elastography and contrast-enhanced ultrasound, respectively, 40, 43 and 42 benign nodules were detected by the three methods. Fifty-nine malignant nodules and 44 benign nodules were diagnosed by ultrasound elastography combined with contrast-enhanced ultrasound. The diagnostic efficacy of ultrasound elastography combined with contrast-enhanced ultrasound in the diagnosis of solid hypoechoic thyroid nodules was higher than that of ultrasound alone; while the diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the combined method were 91.94%, 95.12%, 93.20%, 96.61%, and 88.64%, respectively.Conclusions:Ultrasound elastography combined with contrast-enhanced ultrasound has high diagnostic efficacy in the diagnosis of benign and malignant solid hypoechoic thyroid nodules, and can help guide clinical diagnosis and treatment.