BACKGROUND Solitary thyroid nodules present a challenge in differentiating between benign and malignant conditions using ultrasound (US). Arrival time parameter imaging (At-PI) following contrast-enhanced ultrasound (CEUS) can effectively visualize the vascular architectural patterns of the nodules, providing valuable diagnostic information. This study aimed to explore the application value of At-PI in differentiating thyroid nodules, specifically focusing on a sample of 127 cases. MATERIAL AND METHODS From October 2020 to December 2023, 127 thyroid nodules from 108 patients who underwent ultrasound and CEUS examinations at the General Hospital of Northern Theater Command were reviewed. Pathological outcomes served as the criterion standard, categorizing the nodules into a benign group (44 cases) and a malignant group (83 cases). At-PI was employed to analyze the CEUS videos, allowing for a comparison of parameters between the 2 groups. Additionally, the diagnostic performance of 2 quantitative parameters was assessed using receiver operating characteristic (ROC) curves. RESULTS After conducting the chi-square test, the differences between the 2 groups regarding enhancement time, perfusion pattern, and perfusion defect were found to be statistically significant (P<0.05). There was a significant difference between the 2 groups over the time span (ΔT) (P<0.05). The areas under the curve (AUCs) for ΔT₄₋₃ and ΔT₆₋₅ were 0.715 (95% CI: 0.624-0.805) and 0.763 (95% CI: 0.676-0.851). CONCLUSIONS At-PI can offer more effective parameters for differentiating thyroid nodules. Additionally, some of these parameters exhibit notable diagnostic performance in the detection of thyroid cancer.