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1.Screening
1.1.Inclusion criteria

Age ≥ 18 years old

Yes

Thyroid US indicates thyroid nodule.

Yes

US assessment accords with FNA criteria recommended by C-TIRADS

Yes
/
No

nodule with high insufficient rate

high cystic nodule

Informed consent

Yes

1.2.Exclusion criteria

Allergic to lidocaine or SonoVue

No

Refuse to CEUS

No

Severe abnormality of heart function or lung function

No

Severe abnormality of coagulation function

No

Pregnancy

No

Active infectious focus on cervical skin

No

Patients unable to cooperate for FNA or CEUS

No

2.Preoperative indications
2.1.General information

Registration number

1000701819

Birthday

1982-04-04

Sex

Female

Telephone

13703021987

Date for signing informed consent

2023-05-10

2.2.Preoperative examination

Location of target thyroid nodule

right lobe

transverse diameter

18 mm

Anteroposterior diameter

12 mm

Upper and lower diameter

27 mm

Solid component (%)

20

echo

iso-echo

edge

clear

border

regular

acoustic halo

No

Strong echo within nodule

No

Solid component of sheet-like strong echo (%)

-

Score of ACR TI-RADS

2

Rank of ACR TI-RADS

2

Score of C-TIRADS

0

Rank of C-TIRADS

3

Ultrasonic diagnose

甲状腺良性结节

VCs function evaluated by TLUSG

bilateral VCs moved symmetrically

Routine blood test

Yes

Coagulation function

Yes

3.Intraoperative indications
3.1.Time of aspiration

Date of aspiration

2023-05-11

Start time

15:04

End time

15:11

3.2.Contrast-enhance indication (CEUS-FNA group)

Dosage of SonoVue

3

No enhancement

No

Ratio of enhancement

10

Injection of SonoVue during FNA

No

3.3.Progression of operation

Machine

ARIETTA 70

Local anesthesia

2% lidocaine

other local anaesthesics

-

Dosage of local anaesthesics

3 ml

Patient compliance

good

Aspiration needle

25G

FNA approach

lateral approach

Aspiration times

4

Use of negative pressure

No

Pressure

- ml

Quality of nodule

Soft

Grittiness

No

Sample capacity

much

3.4.Intraoperative instant complication

location

within nodule

visible for bleeding by CDFI

no

extend of hematoma (once after FNA)

18*6*22

methods

no

visible hemorrhage by CDFI 30 minutes after FNA

yes

extend of hematoma (before patient departure)

appearance

vocal cord mobility assessment by ultrasound

methods

whether the voice recovers when the patient leaves

Allergic to contrast agent

No

Painful

Yes

VAS score

3

Analgesic

No

Painful when leave interventional room

No

Haemorrhage

Yes

Voice change

No

Vagal nerve syndrome

No

Horner syndrome

No

Aspiration related acute hypersensitivity reaction

No

4.Follow-up one week after aspiration
4.1.Postoperative cytopathology

Pathological number

Whether sample capacity is enough

Number of observable follicular epithelial cell clusters in specimen

Cytopathology classification

4.15.Physical Sbility Examination
5.Adverse events
1.Adverse events

Record of adverse events

6.Follow-up 2
7.Follow-up 3
8.Management system of participants
9.Speciman management system
10.Data management system
11.ADR/ADE management system
12.Madicine management system
13.Instruments management system
14.SOPs
14.1.Treatment SOP
14.2.Nursing SOP
14.3.Specimen collection SOP
15.Research team
15.1.Institutions
15.2.Researchers
16.Design, Methods
16.1.Calculation of sample size