Today we will talk about the ultrasound performance of thyroid nodules to give you a basic understanding. Thyroid nodules are very common, especially since some units routinely do ultrasound of the thyroid gland during physical examinations, and the wide range of examinations is one of the reasons why more thyroid nodules are found. Whether or not there is now a problem of over-medication of thyroid nodules, I think it is a matter of opinion and wisdom. Due to the development of medical technology, it is sometimes difficult to say whether it is necessarily a good thing that many diseases that were previously undiagnosed are now diagnosed. The control of medical treatment depends on many aspects, including doctors, patients, families, society, etc. There are never absolutes. The understanding of disease is always on the road of development, there is no end and no absolute, this is my personal view. Even though the so-called genetic testing and precision therapy may be able to solve some problems, they are never as good as imagined. As you probably know, and doctors say so, most thyroid nodules are benign. Of those thyroid cancers, most of them are again papillary carcinomas that have very good surgical results, and some may survive long term without surgery. This is because there are many autopsy reports where thyroid cancer is found, but these people did not die of thyroid cancer. Does this mean that thyroid cancer is something to be taken lightly and not cared about? I think no one will not care because even the so-called papillary cancer can develop metastasis in lymph nodes, lungs, and even bones, and once extensive metastasis occurs, the treatment effect will be very poor. In addition, tumor is a chronic disease and each person behaves differently, which is closely related to individual’s genetic base and living environment. What exactly are the factors? How big a role does it play? We are still far from understanding and our knowledge of the disease is far less comprehensive than we think. The best way to detect thyroid nodules is currently considered to be thyroid ultrasound. It is both convenient and free of adverse effects such as radiation. Both the morphology and the blood flow can be seen. Other tests such as CT/MRI are only chosen when the relationship between the tumor and the surrounding area is not clear. What does ultrasound of thyroid nodules mainly look for? 1. Whether the boundary is clear Benign nodules usually have clear boundary, while malignant ones can have unclear boundary because of invasion to surrounding tissues. However, some inflammatory lesions can have exudate and the boundary is not clear. 2, whether the shape is regular benign lesions, the general shape is regular, some surrounding and halo. 3, whether there are dotted strong echogenicity can be seen in two cases: one is colloid, which is a sign of benign. One is calcification. Malignant generally have calcification, and most of them are tiny calcification or gravel-like calcification; but having calcification is not necessarily malignant. 4.Whether there is blood flow inside the tumor or nodule Blood flow is divided into internal blood flow and external blood flow. Malignant ones mostly have internal blood flow disorder. Because the thyroid gland is an organ rich in blood flow, the blood flow of the gland is usually richer. In the case of hyperthyroidism, the blood flow is even richer and flame-like. 5. Whether the nodule is growing longitudinally That is, whether the longitudinal diameter of the thyroid nodule is larger than the transverse diameter, that is, whether the aspect ratio is greater than 1. If so, the possibility of malignancy also needs to be considered. 6, whether there are lymph nodes or surrounding infiltrates whether the nodule has adhesions with the surrounding tissues, whether the lymph nodes are poorly demarcated by the skin medulla. If there is distant metastasis, it is definitely malignant. Of course, nowadays, tumors are found early and there are not many distant metastases. However, not every node has all the above ultrasound findings, which requires specific analysis. In short, the more manifestations, the higher the possibility of malignancy. Of course, ultrasound examination, the doctor’s experience and the resolution of the machine have a great influence on the judgment of ultrasound results, I generally believe in the ultrasound done by our doctors, but some external examinations are suspicious and I suggest to review them.