目的探讨钙化在甲状腺微小癌(thyroid microcarcinoma,TMC)中的表达及超声诊断意义。方法回顾分析68例TMC和60例甲状腺良性疾病的病灶钙化情况和相关资料。结果 TMC和甲状腺良性疾病病灶钙化超声检出率分别为67.6%和33.3%(P<0.01);病理检查结果病灶钙化率分别为72.1%和35.0%(P<0.01)。微钙化在良、恶性钙化结节中所占比例各为20.8%和79.2%(P<0.01)。结节钙化中有70.0%为恶性,无钙化结节中32.8%为恶性(P<0.01)。TMC病灶微钙化发生率为55.9%,乳头状癌微钙化率为72.5%。女性及年龄<45岁TMC患者的病灶钙化率较良性疾病均明显为高,(P<0.01)。结论 TMC绝大多数为乳头状癌,微钙化是TMC特异性最高的超声表现特征,对TMC的诊断有十分重要意义。 Objective To investigate the expression of calcification in thyroid microcarcinoma (TMC) and the significance of ultrasonic diagnosis. Methods A retrospective analysis of 68 cases of TMC and 60 cases of benign thyroid disease calcification and related information. Results The frequencies of calcification of TMC and thyroid benign lesions were 67.6% and 33.3%, respectively (P <0.01). The pathological examination showed a calcification rate of 72.1% and 35.0%, respectively (P <0.01). The proportion of micro-calcifications in benign and malignant calcified nodules was 20.8% and 79.2% respectively (P <0.01). 70.0% of nodular calcifications were malignant, and 32.8% of nodules without calcification were malignant (P <0.01). The incidence of microcalcifications in TMC lesions was 55.9% and that of papillary carcinoma was 72.5%. The calcification rate of lesions in women with TMC <45 years old was significantly higher than that in benign diseases (P <0.01). Conclusion The vast majority of TMCs are papillary carcinoma. Microccalcification is the most characteristic ultrasonographic manifestation of TMC, which is of great significance for the diagnosis of TMC.