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1.Screening
1.1.Inclusion criteria

Informed consent

nodule with high insufficient rate

US assessment accords with FNA criteria recommended by C-TIRADS

Thyroid US indicates thyroid nodule.

Age ≥ 18 years old

1.2.Exclusion criteria

Severe abnormality of coagulation function

Severe abnormality of heart function or lung function

Refuse to CEUS

Allergic to lidocaine or SonoVue

Patients unable to cooperate for FNA or CEUS

Active infectious focus on cervical skin

Pregnancy

2.Preoperative indications
2.1.General information

Date for signing informed consent

Telephone

Sex

Birthday

Registration number

2.2.Preoperative examination

border

edge

echo

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

3.Intraoperative indications
3.1.Time of aspiration

End time

Start time

Date of aspiration

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

No enhancement

Dosage of SonoVue

Injection of SonoVue during FNA

Ratio of enhancement

3.3.Progression of operation

Sample capacity

Grittiness

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

3.4.Intraoperative instant complication

Allergic to contrast agent

extend of hematoma (before patient departure)

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

whether the voice recovers when the patient leaves

Analgesic

methods

VAS score

vocal cord mobility assessment by ultrasound

Painful

appearance

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