Abstract: 【Objective】 To evaluate the efficiency of conventional ultrasound (CUS)

contrast-enhanced ultrasound (CEUS)

shear wave elastography (SWE)

and their different combinations for the differential diagnosis of benign and malignant thyroid nodules.【Methods】 45 patients were recruited from the out-patient clinic of the first affiliated hospital of Sun Yat-Sen University. The predictive value of conventional US

CEUS

and SWE were collected and compared with pathology of core needle biopsy or surgery.【Results】 A total of 35 benign and 10 malignant lesions were analyzed. Characteristics of SWE (cutoff

39.3 kPa) were: sensitivity = 90.0%

and specificity = 80.0%. The AUC was 0.850. Characteristics of the CUS Score were: sensitivity = 70.0%

and specificity = 74.3%. Characteristics of the CEUS Score were: sensitivity=66.7%

and specificity=75.0%. When used in combination

“conventional US or SWE” and “CEUS or SWE” both gained a sensitivity of 100%. The combination of “conventional US and SWE” improved the specificity to 85.7%.【Conclusion】 SWE may be the most efficient sonographic technique for evaluation of thyroid nodules

and the combination of conventional US and SWE in an “and” / “or” rule may bring further improvement of specificity and sensitivity in the differential diagnosis of benign and malignant thyroid nodules.