Objective To evaluate the differential diagnosis value of shear wave elastography for Hashimoto's disease with benign or malignant thyroid nodules.Methods Fifty four patients of Hashimoto's disease confirmed by biopsy or pathology were enrolled.Based on benign or malignant of nodules,patients were divided into benign nodules group and malignant nodules group.And the benign group were divided into true nodules and sham nodules.Young's modulus values were measured and compared among different groups.The ROC curve was drawn to evaluate the diagnostic efficency.Results There were tatol 162 nodules in 54 cases with Hashimoto's disease,including 131 of benign nodules (93 of true nodules,38 of sham nodules) and 31 of malignant nodules.The values of Young's modulus for benign,malignant,ture nodules and sham nodules were (33.04±10.95)kPa,(66.15±19.17)kPa,(35.95±9.74)kPa and (30.13±11.87)kPa.For mean values of Young's modulus,there was significantly statistical difference between benign and malignant nodules (t=12.91,P＜0.01).There was significant statistical difference of the Young's modulus among sham nodule group,true nodule group and malignant nodule group (F 36.20,P＜0.01).Compared with the other two groups,the value of Young's modulus in malignant nodules was significantly higher than that in the other two groups (both P＜0.01).Taking 43.65 kPa as the diagnostic point,the sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio of Youngs modulus in diagnosis of benign and malignat nodules were 90.63％,81.25％,4.83,and 0.12.Conclusion Shear wave elastography technique can quantitative analysis the Hashimoto's disease and complicated nodules,which is helpful to determine the essence of the nodules.