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1.Screening
1.1.Inclusion criteria

Age ≥ 18 years old

Thyroid US indicates thyroid nodule.

US assessment accords with FNA criteria recommended by C-TIRADS

nodule with high insufficient rate

Informed consent

1.2.Exclusion criteria

Allergic to lidocaine or SonoVue

Refuse to CEUS

Severe abnormality of heart function or lung function

Severe abnormality of coagulation function

Pregnancy

Active infectious focus on cervical skin

Patients unable to cooperate for FNA or CEUS

2.Preoperative indications
2.1.General information

Registration number

Birthday

Sex

Telephone

Date for signing informed consent

2.2.Preoperative examination

Location of target thyroid nodule

transverse diameter

mm

Anteroposterior diameter

mm

Upper and lower diameter

mm

Solid component (%)

echo

edge

border

acoustic halo

Strong echo within nodule

Solid component of sheet-like strong echo (%)

Score of ACR TI-RADS

Rank of ACR TI-RADS

Score of C-TIRADS

Rank of C-TIRADS

Ultrasonic diagnose

VCs function evaluated by TLUSG

Routine blood test

Coagulation function

3.Intraoperative indications
3.1.Time of aspiration

Date of aspiration

Start time

End time

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

Dosage of SonoVue

No enhancement

Ratio of enhancement

Injection of SonoVue during FNA

3.3.Progression of operation

Machine

Local anesthesia

other local anaesthesics

Dosage of local anaesthesics

ml

Patient compliance

Aspiration needle

FNA approach

Aspiration times

Use of negative pressure

Pressure

ml

Quality of nodule

Grittiness

Sample capacity

3.4.Intraoperative instant complication

Allergic to contrast agent

Painful

VAS score

Analgesic

Painful when leave interventional room

Haemorrhage

Voice change

Vagal nerve syndrome

Horner syndrome

Aspiration related acute hypersensitivity reaction

location

visible for bleeding by CDFI

extend of hematoma (once after FNA)

methods

visible hemorrhage by CDFI 30 minutes after FNA

extend of hematoma (before patient departure)

appearance

vocal cord mobility assessment by ultrasound

methods

whether the voice recovers when the patient leaves

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