The purpose of this multicenter study was to compare the differential diagnostic value of the 2015 American Thyroid Association (ATA) and 2017 American College of Radiology (ACR) practice guidelines and elastography in thyroid nodules. This study also investigated whether the diagnostic value of practice guidelines can be improved, and the unnecessary biopsy rate decreased in combination with elastography. A total of 498 thyroid nodules were evaluated using the ATA and the ACR guidelines. Strain elastography, acoustic radiation force impulse imaging and point-shear wave elastography were used to assess the nodules. The suspicious levels were downgraded or upgraded after combination and unnecessary biopsy rates were calculated, respectively. The diagnostic performance of the practice guidelines was better than that of elastography. The ACR guidelines had a lower unnecessary biopsy rate and similar diagnostic performance compared with the ATA guidelines. The unnecessary biopsy rates significantly decreased when the ACR guidelines were combined with elastography, but the rates did not decrease when the ATA guidelines were combined with elastography.

这项多中心研究的目的是比较 2015 年美国甲状腺协会 (ATA) 和 2017 年美国放射学会 (ACR) 实践指南和弹性成像对甲状腺结节的鉴别诊断价值。本研究还探讨了是否可以提高实践指南的诊断价值，并结合弹性成像降低不必要的活检率。使用 ATA 和 ACR 指南评估了总共 498 个甲状腺结节。应变弹性成像、声辐射力脉冲成像和点剪切波弹性成像用于评估结节。合并后可疑水平被降级或升级，并分别计算不必要的活检率。实践指南的诊断性能优于弹性成像。与 ATA 指南相比，ACR 指南具有较低的不必要活检率和相似的诊断性能。当 ACR 指南与弹性成像相结合时，不必要的活检率显着降低，但当 ATA 指南与弹性成像相结合时，不必要的活检率没有降低。