Objective To investigate the value of contrast-enhanced ultrasonography and multi-slice spiral CT in differential diagnosis of benign and malignant thyroid nodules and the imaging findings of thyroid adenomas. Methods Forty-six cases of patients with thyroid adenomas and 28 cases of patients with papillary thyroid carcinomas were selected as study subjects. All patients were confirmed by pathological examination and underwent preoperative contrast-enhanced ultrasonography and multi-slice spiral CT examination. The value of the two methods in the differential diagnosis of benign and malignant nodules was compared. The imaging findings were analyzed. Results There was no significant difference in sensitivity between contrast-enhanced ultrasonography and multi-slice spiral CT in differential diagnosis of benign and malignant thyroid nodes (P>0.05). The specificity and accuracy of multi-slice spiral CT in differential diagnosis of benign and malignant thyroid nodules were significantly lower than those of contrast enhanced ultrasonography (P<0.05). CT plain scan of 46 patients with thyroid adenomas mainly showed homogeneous and low-density lesions, with clear boundaries, few calcification signs and cystic lesions. Only a few boundaries were unclear, and the density was inhomogeneous. The enhanced scan of 40 patients showed there was enhancement in solid part of the lesions, and the density was significantly higher than that of the normal tissues around the lesions. Among the 46 subjects, the findings of contrast-enhanced ultrasonography in 44 patients showed high enhancement (95.7%), with presence of partial annular enhancement bands, and 2 cases (4.3%) with homogeneous enhancement, showing homogeneous enhancement. Conclusion Both of contrast-enhanced ultrasonography and multi-slice spiral CT have specific imaging findings in thyroid adenomas. In clinic, the combination of the two can be used as an effective means for differential diagnosis of benign and malignant thyroid nodules to reduce the risk of misdiagnosis and improve the prognosis.