Objective:The aim of this study is to assess the application value of maximum Young's modulus of shear wave elastography in combination with Thyroid Imaging Reporting and Data System set by the American College of Radiology in the diagnosis of benign and malignant thyroid nodules. Method:A retrospective analysis of 113 thyroid nodules with ultrasonographic imaging data was carried out. All nodules were subjected to SWE and conventional ultrasonography, and Emax was recorded and classified according to the 2017 ACR TI-RADS. With pathology as the gold standard, the ROC curve was drawn and the best diagnostic cut-off was selected for comparing their diagnostic performance. Result:Of the 113 thyroid nodules, 51 were benign and 62 were malignant. Best cut-off point for diagnosing malignant by SWE was Emax>40 kPa. And at that point, the sensitivity, specificity and accuracy of the average value of it were 74.2%, 76.5% and 75.2 %. Best cut-off point for diagnosing malignant by ACR TI-RADS was>TR4. The sensitivity, specificity and accuracy of the average value of it were 80.6%, 78.4% and 79.6%. The sensitivity of the combination of the two examinations was significantly higher than that of simple application of each of them, while there was no significant difference in the specificity and accuracy between them. Conclusion:The SWE and ACR TI-RADS classification systems have important clinical value in identifying the benign and malignant thyroid nodules. The combination of the two methods can improve the sensitivity, specificity and accuracy of the diagnosis.