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目的 分析甲状腺微小结节的常规超声及超声造影表现,提高其诊断准确率.方法 回顾性分析经病理检查证实的甲状腺结节患者146例,共178个结节,均直径≤1 cm,其中良性结节61个,恶性结节117个.术前均行常规超声及超声造影检查,经多元逻辑回归分析不同超声征象对诊断恶性结节的意义.结果 各种征象中,以极低回声、纵横比>1、早期低增强、低增强、微钙化、不均匀增强及增强后边界模糊为诊断甲状腺癌的独立预测因素,其中极低回声(OR=31)、早期低增强(OR=30)为最佳预测征象.结论 对于甲状腺微小癌的诊断,需以二维超声表现为依据,超声造影可提供一定的帮助.“,”Objective To evaluate the image features of conventional ultrasound and contrast-enhanced ultrasound (CEUS) in thyroid micro-nodules,and to improve its diagnostic accuracy. Methods A retrospective analysis of 146 cases(178 nodules,diameter≤1 cm) with thyroid micro-nodule which were diagnosed by pathology was carried out,including 61 benign and 117 malignant micro-nodules. All patients underwent conventional ultrasound and CEUS. Diagnostic performance was evaluated by multiple logistic regression analysis.Results Of all the ultrasound signs,marked hypo-echogenicity,taller than wide, early hypo -enhancement,hypo -enhancement,micro -calcification,heterogeneous enhancement and poorly defined margin after enhancement were independent predictor of thyroid carcinoma. The best independent predictors were marked hypo-echogenicity (OR=31) and early hypo-enhancement (OR=30).Conclusion In the diagnosis of thyroid micro-nodules,CEUS is a promising tool,but it must be combined with conventional ultrasound.