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1.Screening
1.1.Inclusion criteria

Age ≥ 18 years old

Yes

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

1.2.Exclusion criteria

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

Allergic to lidocaine or SonoVue

No

2.Preoperative indications
2.1.General information

Date for signing informed consent

2023-05-16

Telephone

15767853793

Sex

Female

Birthday

1998-05-29

Registration number

1001433026

2.2.Preoperative examination

Ultrasonic diagnose

甲状腺良性结节

Rank of C-TIRADS

3

Score of C-TIRADS

0

Rank of ACR TI-RADS

2

Score of ACR TI-RADS

2

Solid component of sheet-like strong echo (%)

-

Strong echo within nodule

No

acoustic halo

No

border

regular

edge

clear

echo

iso-echo

Solid component (%)

20

Upper and lower diameter

32 mm

Anteroposterior diameter

18 mm

Coagulation function

Yes

transverse diameter

27 mm

Routine blood test

Yes

Location of target thyroid nodule

right lobe

VCs function evaluated by TLUSG

bilateral VCs moved symmetrically

3.Intraoperative indications
3.1.Time of aspiration

End time

18:33

Start time

18:26

Date of aspiration

2023-05-16

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

Injection of SonoVue during FNA

No

Ratio of enhancement

30

No enhancement

Yes

Dosage of SonoVue

2

3.3.Progression of operation

Aspiration needle

25G

Patient compliance

good

Dosage of local anaesthesics

4 ml

other local anaesthesics

-

Local anesthesia

2% lidocaine

Machine

GE logiq E9

Sample capacity

medium

Grittiness

No

Quality of nodule

Soft

Pressure

- ml

Use of negative pressure

No

Aspiration times

4

FNA approach

lateral approach

3.4.Intraoperative instant complication

Horner syndrome

No

Vagal nerve syndrome

No

whether the voice recovers when the patient leaves

Voice change

No

methods

Haemorrhage

No

vocal cord mobility assessment by ultrasound

Painful when leave interventional room

No

appearance

Analgesic

No

extend of hematoma (before patient departure)

VAS score

3

visible hemorrhage by CDFI 30 minutes after FNA

Painful

Yes

methods

Allergic to contrast agent

No

extend of hematoma (once after FNA)

visible for bleeding by CDFI

location

Aspiration related acute hypersensitivity reaction

No

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