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1.Screening
1.1.Inclusion criteria

Informed consent

Yes

nodule with high insufficient rate

high cystic nodule

US assessment accords with FNA criteria recommended by C-TIRADS

Yes
/
No

Thyroid US indicates thyroid nodule.

Yes

Age ≥ 18 years old

Yes

1.2.Exclusion criteria

Allergic to lidocaine or SonoVue

No

Patients unable to cooperate for FNA or CEUS

No

Active infectious focus on cervical skin

No

Pregnancy

No

Severe abnormality of coagulation function

No

Severe abnormality of heart function or lung function

No

Refuse to CEUS

No

2.Preoperative indications
2.1.General information

Date for signing informed consent

2023-05-12

Telephone

-

Sex

Female

Birthday

-

Registration number

0001067698

2.2.Preoperative examination

Solid component (%)

Upper and lower diameter

mm

Anteroposterior diameter

mm

Coagulation function

transverse diameter

mm

Routine blood test

Location of target thyroid nodule

VCs function evaluated by TLUSG

Ultrasonic diagnose

Rank of C-TIRADS

Score of C-TIRADS

Rank of ACR TI-RADS

Score of ACR TI-RADS

Solid component of sheet-like strong echo (%)

Strong echo within nodule

acoustic halo

border

edge

echo

3.Intraoperative indications
3.1.Time of aspiration

Start time

Date of aspiration

End time

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

Injection of SonoVue during FNA

Ratio of enhancement

No enhancement

Dosage of SonoVue

3.3.Progression of operation

Quality of nodule

Pressure

ml

Use of negative pressure

Aspiration times

FNA approach

Aspiration needle

Patient compliance

Dosage of local anaesthesics

ml

other local anaesthesics

Local anesthesia

Machine

Sample capacity

Grittiness

3.4.Intraoperative instant complication

visible hemorrhage by CDFI 30 minutes after FNA

methods

extend of hematoma (once after FNA)

visible for bleeding by CDFI

location

Aspiration related acute hypersensitivity reaction

Horner syndrome

Vagal nerve syndrome

Voice change

Haemorrhage

Painful when leave interventional room

Analgesic

whether the voice recovers when the patient leaves

VAS score

methods

Painful

vocal cord mobility assessment by ultrasound

Allergic to contrast agent

appearance

extend of hematoma (before patient departure)

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

Cytopathology classification

Number of observable follicular epithelial cell clusters in specimen

Whether sample capacity is enough

Pathological number

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