Therefore, this study aimed to evaluate the diagnostic utility of preoperative thyroid function profiles and CEUS features in distinguishing FTA from FTC; and develop a composite diagnostic model to enhance preoperative FTC detection; Additionally, this represents the first large-scale study to systematically evaluate the diagnostic efficacy of the noninvasive Tg/Vol ratio as a novel discriminator for thyroid follicular neoplasms. Here, TG is linked to thyroiditis.