Objective To explore the value of color doppler twinkling artifact behind hyperechoic regions in thyroid nodules.Methods 88 thyroid nodulars with hyperechoic regions were devided into two teams by preset application of color doppler vessel flow:Team A,nodulars get a positive result of twinkling artifact behind hyperechoic regions;Team B,nodulars get a negative result of twinkling artifact behind hyperechoic regions.The pathologic data of two teams were compared.Results The malignant rate of Team A is 86.7%（26/30）,while the malignant rate of Team B is 17.2%（10/58）. The difference between two teams is statistically significant（χ2=39.4，P<0.05）.Conclusion The occurrence of color doppler twinkling artifact behind hyperechoic regions in thyroid nodules is helpful for malignant diagnosis．