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目的：探讨甲状腺微小结节的超声诊断，筛选出超声诊断甲状腺微小癌的主要诊断指标及次要诊断指标。方法回顾性分析经手术和病理证实的129例最大结节直径≤1 cm 的甲状腺病变患者的临床资料，共213个病灶，结节直径2~10 mm，其中良性结节118个，恶性结节95个。二维超声观察甲状腺微小结节的超声声像图特征，记录结节单发或多发情况、纵横比、形态、边界、边缘、内部回声水平、内部回声结构、钙化、淋巴结转移情况等，并计算各个超声诊断指标诊断甲状腺微小癌的优势比（OR 值），筛选出超声诊断甲状腺微小结节良恶性的主要诊断指标及次要诊断指标。结果甲状腺良性及恶性微小结节在发生情况及结节的纵横比、形态、边界、边缘、内部回声水平、回声是否均匀、钙化、淋巴结转移情况等声像图指标中差异有统计学意义（P <0.05）；超声诊断甲状腺恶性微小结节的主要诊断指标有纵横比≥1、边缘不光整、极低回声、实性、微钙化，次要诊断指标有单发、类圆形、不规则形、边界模糊、内部回声不均匀。结论超声在诊断甲状腺微小癌方面具有重要价值；综合考虑甲状腺微小结节的超声表现，可提高甲状腺微小癌的检出率，减少误诊及漏诊。“,”Objective To investigate the ultrasound diagnosis of thyroid micronodules,screen the main and secondary diagnostic indicators of thyroid microcarcinoma. Methods The clinical data of 213 small thyroid nodules with 129 cases who were pathologically confirmed were retrospectively re-viewed,including 118 benign nodules and 95 malignant nodules. Its single or multiple,anteroposterior to transverse dimension ratio,configuration,borders,margin,internal echo,internal solid / cystic component, calcification and cervical lymph node metastasis were observed by 2D ultrasonography,and calculated the odds ratio of each ultrasound diagnostic indicators,screened the main and secondary diagnostic indicators of thyroid microcarcinoma. Results The single or multiple,anteroposterior to transverse dimension ra-tio,configuration,borders,margin,internal echo,internal solid / cystic component,calcification and cervical lymph node metastasis was significantly different between benign and malignant thyroid mi-cronodules(P < 0. 05);The main diagnostic indicators of thyroid microcarcinoma had taller-than-wide sign,edge burr,marked hypoechoic,solid,microcalcification,the secondary diagnostic indicators have single,like round,irregular shape,fuzzyedge,internal echo inequality. Conclusions The ultrasound have great value in the diagnosis of thyroid microcarcinoma;the detection rate of thyroid microcarci-noma can be improved by comprehensive considerate the sonographic features to reduce the misdiagnosis and missed diagnosis.