الفهرس 
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Abstract
Thyroid nodules are very common and found in 4% to 8% of adults by palpation, 41% by ultrasound, and 50% by pathologic examination and biopsy. Most nodules are benign, with less than 5% of them being malignant.
Cytological examination of material obtained by fine needle aspiration (FNA), due to its high sensitivity and specificity, is the best single test for differentiating malignant from benign thyroid lesions. Yet, a substantial proportion of nodules are not correctly diagnosed before surgical treatment, and histological examination is required.
Sonography has many favorable features, such as detection of non-palpable nodules, estimation of nodule size, and guidance for fine needle biopsy (FNB). High-resolution ultrasound is very sensitive in detection of thyroid nodules, enabling differentiation of solid and cystic lesions.
Indeterminate and non diagnostic patterns represent the main limitation of fine needle aspiration (FNA) cytology of thyroid nodules, clinical and echographic features being poorly predictive of malignancy. The newly developed real-time ultrasound elastography (USE) has been previously applied to differentiate malignant from benign lesions. The principle of USE is to acquire two ultrasonographic images (before and after tissue compression by the probe), and to track tissue displacement by assessing the propagation of the US beam by a dedicated software. The US elastogram was displayed over the B-mode image in a color scale that ranged from red. for components with greatest elastic strain (i.e. softer components), to blue for those with no strain (i.e. harder components).
The purpose of this study was to evaluate indeterminate thyroid nodules by US elastography.
In this study, 20 cases were included from which 18 cases were benign and 2 cases were malignant.The cases were subjected to complete U/S, Doppler examination, and US elastography the results were compared to U/S guided FNAC.
We conclude that US-elastography is a promising technique that, combined with other US modalities, is easy and rapid to perform and can help to identify thyroid nodules that are likely to be malignant.
In our opinion, further studies are necessary before being able to conclude about the place of elastography in thyroid nodules evaluation, versus fine-needle aspiration cytology (FNAC), the gold standard. Indeed, elastography could reduce FNAC or at least allow to select nodule’s (or nodular zone’s) for aspirations.