Abstract:  Objective  To explore the value of ultrasonic strain elastography (SE) combined with supermicro blood flow imaging (SMI) in the identification of thyroid nodules. Methods  The imaging and clinical data of 80 patients with thyroid nodules who were examined from May 2019 to August 2020 were selected, and pathological examination results were used as the gold standard, and patients were divided into benign group (n=34) and malignant group (n=46), SE and SMI were performed in both groups. The ultrasound elasticity scoring standard was used to evaluate the results of SE detection of thyroid nodules, the results of SMI detection of thyroid nodules were evaluated according to Alder blood flow classification, and receiver operating characteristic curve (ROC)was used to analyze the diagnostic efficiency of SE and SMI alone and in combination in the diagnosis of thyroid nodules. ResultsThe ultrasonic elastic score of malignant thyroid nodules detected by SE was significantly higher than that of benign nodules (P=0.000). A total of 38 cases of malignant nodules were detected, including 5 cases in benign group and 33 cases in malignant group. Taking 4 points as the cut-off value, the malignant rate of 1-3 points was 31.0% (13/42), and the malignant rate of 4-5 points was 86.8% (33/38). The Alder blood flow grade of malignant thyroid nodules detected by SMI was significantly higher than that of benign nodules (P = 0.000). A total of 39 cases of malignant nodules were detected, including 7 cases in benign group and 32 cases in malignant group. Taking grade 2 as the cut-off value, the malignant rate of grade 0-1 was 34.1% (14/41), and the malignant rate of grade 2-3 was 82.1% (32/39). In the diagnosis of benign and malignant thyroid nodules, the sensitivity of SE, SMI and their combination were 0.690, 0.659 and 0.871 respectively, the specificity were 0.868, 0.821 and 0.857 respectively, the accuracy were 0.775, 0.738 and 0.863 respectively, and the areas under the ROC curve were 0.785, 0.745 and 0.854 respectively. Conclusion  Compared with separate diagnosis, the combined diagnosis of SE and SMI can effectively improve the diagnostic efficiency of benign and malignant thyroid nodules, and has a higher reference value.

Key words: Thyroid nodules')">">, Ultrasonic strain elastography')">">, Ultra-micro blood flow imaging">-micro blood flow imaging')">">, Diagnosis