Objective To analyze the ultrasonic features of thyroid microcarcinoma (TMC) and the causes of misdiagnosis. Methods The ultrasonic features including shape, margin, echogenecity, microcalcification, vascularity and lymphadenopathy were analyzed retrospectively in 26 pathologically-proven TMC patients. Results In 26 cases, 11 cases were diagnosed correctly before operation (11/26, 42.31%), 12 cases were misdiagnosed (12/26, 46.15%) as adenoma or benign nodule, and 3 cases were missed diagnosed (3/26, 11.54%). Among the 23 cases detected on ultrasound, 21 cases were solid and hypoechoic (21/23, 91.30%);19 cases were ill-defined (19/23, 82.61%);12 cases were taller than wide in shape (12/23, 52.17%); 14 cases had microcalcification (14/23, 60.87%); 7 cases showed central or peripheral blood flow signals (7/23,30.43%) with arterial resistance index>0.70 in 3 lesions and<0.70 in 4 lesions. Conclusions Several ultrasonographic features are helpful in identiifcation of TMC, including hypo/iso-echogenecity, ill-deifned margin, taller-than-wide shape, microcalciifcation, arterial signals with high resistance index, and abnormal lymphadenopathy. Moreover, for cases with multiple lesions, to the potential co-existence of benign and malignant lesions should be considered.%目的：分析甲状腺微小癌的超声特点及漏误诊原因。方法回顾性分析26例经手术病理证实的甲状腺微小癌的声像图特征，包括病灶的形态、边界、回声强度、是否有微钙化、彩色多普勒血流成像和是否有淋巴结转移等。结果26例中11例（11/26，42.31%）术前诊断与病理符合，12例（12/26，46.15%）误诊为小腺瘤或良性结节，3例（3/26，11.54%）漏诊。超声检出的23例中21个为实性低回声（21/23，91.30%）；19个边界模糊（19/23，82.61%）；12个前后径和横径之比≥1（12/23，52.17%）；14个探及微钙化（14/23，60.87%）；7个彩色多普勒血流成像显示肿瘤周边或内部血流信号（7/23，30.43%），动脉频谱显示3个阻力指数＞0.70，4个阻力指数＜0.70。结论甲状腺微小癌二维超声显示结节呈低回声或等回声、边界模糊，肿瘤的前后径和横径之比≥1，肿块周边或内部可见微钙化，且彩色多普勒血流成像显示高阻动脉血流信号、颈部中央区可见肿大淋巴结时，应当高度警惕甲状腺微小癌的可能，尤其对多结节病灶，应警惕良恶性并存。
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