Thyroid nodule category 4b, generally not very likely to be downgraded, but may remain in its current state without progression. TI- RADS classification is a commonly used clinical grading method for thyroid nodules, which is divided into 6 grades, of which 4 is a suspected malignant lesion, 4a is low suspicion of malignancy, 4b is moderate suspicion of malignancy, and 4c is high suspicion of malignancy. Thyroid nodule 4b suggests that the probability of malignant nodule is about 10-50%, the possibility of downgrading is unlikely, it is recommended that further pathologic examination. If the examination clearly diagnosed as benign nodules, generally no treatment is needed, and regular review in the hospital is sufficient; if the pathological examination for malignant nodules, or the emergence of compression symptoms, such as dyspnea, dysphagia, palpitations (heartbeat accelerated, often accompanied by panic), etc., you need to take timely surgical resection treatment. It is recommended that patients with diagnosed grade 4b thyroid nodules be treated under the guidance of a doctor.