Objective: To evaluate the diagnostic value of routine ultrasonography combined with elastosonography in diagnosing papillary thyroid microcarcinoma (PTMC).  
Methods: The studies concerning routine ultrasonography combined with elastosonography for diagnosis of PTMC both in Chinese and in English were searched in several national and international online databases. Search period was set from 2013 to August 2018. After strict screening and data extraction by two reviewers according to the predefined inclusion and exclusion criteria, the risk of bias of the included studies was assessed by QUADAS-2 tool, and Meta-analysis was performed using STATA12.0 and Meta-Disc 1.4 software.
Results: Sixteen studies were finally included involving 2 826 lesions. Random effects model was used for Meta-analysis due to the substantial heterogeneity of the included studies. The obtained results showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for diagnosis of PTMC were 0.91 (95% CI=0.89–0.92), 0.90 (95% CI=0.89–0.92), 8.94 (95% CI=5.45–14.65), 0.09 (95% CI= 0.05–0.16) and 103.05 (95% CI=52.06–203.98) respectively, and the area under the SROC curve was 0.9657 (the Q index was 0.9130). The Deek’s plot showed no significant publication bias (P=0.485).
Conclusion: Routine ultrasonography combined with elastosonography has a relatively high diagnostic efficiency for detecting PTMC, which provides a feasible method for diagnosis of PTMC.