Many people do not have a specific understanding of elastography, which refers to the use of lesion colors to distinguish the severity of thyroid conditions during thyroid examinations. Elastography scores generally range from 0 to 4. A score of 3 indicates a relatively severe condition, necessitating further examination to identify the cause and undergo proper treatment. Let's explore this topic further.

I. Is an Elastography Score of 3 Severe?

Elastography assigns scores from 0 to 4 based on the different colors displayed in the lesion areas of organs such as the thyroid. A score of 3 indicates a chaotic distribution of blue and green in the lesion area, suggesting relatively high stiffness. Take thyroid nodules as an example; scores below 3 are often considered benign, while scores of 3 or above suggest a risk of malignancy. However, elastography alone cannot definitively determine malignancy. Close observation of the lesion is necessary, with follow-up examinations every three to six months. Two-dimensional ultrasonography can also be used to determine if biopsy is needed to clarify the nature of the lesion.

II. Elastography Scoring Criteria

Elastography is not widely used, but some doctors still perform it. The scoring criteria are as follows: Based on the different colors and stiffness displayed in the nodule or tumor area, elastography assigns five grades. Grade 1 nodules have cystic components and appear as red, blue, or a combination of red and blue/green. Grade 2 nodules and surrounding tissues appear uniformly green. Grade 3 nodules have a green periphery and a blue center. Grade 4 nodules have a chaotic distribution of green and blue. Grade 5 nodules are surrounded by or completely covered in blue. The first three grades are considered benign, while the last two grades suggest malignancy and require further imaging examination for confirmation.

III. What is Elastography?

Elastography is a new imaging modality in ultrasonography, distinct from traditional two-dimensional and color Doppler ultrasonography. It utilizes differences in tissue stiffness to produce images, distinguishing between soft and hard tissues. Normal and pathological tissues often differ in stiffness, with malignant lesions in organs like the thyroid or breast being relatively stiff. Therefore, elastography provides supplementary information regarding tissue stiffness. Currently, there are two main types of elastography: strain elastography and shear wave elastography. It is applied to organs such as the superficial thyroid, breast, and lymph nodes, as well as for staging liver fibrosis in the abdomen. Elastography serves as a supplementary tool and should be combined with two-dimensional and color Doppler ultrasonography for comprehensive diagnosis. However, not all hospitals have this technology, and it is not widely used in clinical practice.