What is “elastography”? Diagnostic ultrasound technology has become a cornerstone in the clinical evaluation and management of thyroid nodules, but is less effective in the differential diagnosis of benign and malignant nodules. Although the sensitivity and accuracy of “ultrasound-localized fine needle aspiration histology” is over 90%, the invasive nature of the test, the difficulty of performing it in most tertiary care hospitals in China, and the false-negative rate of the test still leave patients and physicians in a difficult position. In recent years, the development of ultrasound elastography has provided a new non-invasive diagnostic method for identifying benign and malignant thyroid nodules. The technique is designed to detect the difference in hardness between tissues to reflect the biological characteristics of the lesion itself, thus achieving the purpose of identifying benign and malignant. Elastography scoring criteria The performance of elastography is graded as V (0~4 points) according to the different colors (different relative hardness) displayed in the lesion area: 0 points, the lesion area is dominated by cystic components, showing red-blue or blue-green-red interactions. 1 point, the lesion appears uniformly green with the surrounding tissue. 2 points, the lesion area is predominantly green with a blue periphery. 3 points, the lesion area shows a haphazard blue-green distribution. 4 points, the lesion area is completely covered by blue or the surrounding area is blue. An elasticity score of 3 was used as the diagnostic cut-off point, with ≥3 being malignant and <3 being benign. Reliability of elasticity score Ultrasound elastography extends the scope of application of ultrasound by examining lesions from the perspective of tissue elasticity, and provides a new reliable evaluation tool for the qualitative diagnosis of thyroid nodules. At present, clinical studies at home and abroad have confirmed that the sensitivity, specificity and accuracy of ultrasound elastography in the diagnosis of malignant thyroid nodules are close to 90%.