分析甲状腺转移癌（TM）常规超声及超声造影（CEUS）特征，提升超声医师对TM的影像学识别能力与临床诊断水平。

回顾性收集2015年1月至2024年12月期间苏州大学附属第一医院经病理确诊的TM患者17例，记录其临床特征，并由2名医师对超声图像进行判读，分析TM的常规超声和CEUS特征。

本研究共纳入17例经病理证实的TM患者，原发肿瘤来源依次为：肺癌及食管癌各5例（29.41%），喉癌3例（17.65%），鼻咽癌、胰腺癌、胸部软骨肉瘤、乳腺癌各1例（5.88%）。临床表现方面，41.18%（7/17）的患者短期内病灶明显增大、23.53%（4/17）出现呼吸困难、58.82%（10/17）出现声音嘶哑、47.06%（8/17）伴吞咽哽噎。常规超声显示，病灶累及单侧叶者14例（82.35%），累及双侧叶者3例（17.65%）；病灶以结节型（88.24%，15/17）、低回声（82.35%，14/17）、边缘模糊或不规则或向甲状腺外延伸（88.24%，15/17）为主，弥漫型2例（11.76%）。47.06%（8/17）为囊实性；23.53%（4/17）可见粗大钙化，35.29%（6/17）可见微钙化。CEUS图像特征：CEUS资料完整的10例患者中，8例（80.00%）表现为不均匀增强，8例（80.00%）可见灌注缺损区；增强强度方面，呈低增强者与等/高增强者各占50.00%。

TM在常规超声与CEUS中表现出一定影像学特征，结合患者的原发病史及临床症状，应用多模态超声有助于提高对TM的早期识别与准确诊断。

To investigate the utility of conventional ultrasound and contrast-enhanced ultrasound (CEUS) in the diagnosis of thyroid metastases (TM), aiming to enhance the imaging-based recognition and clinical diagnostic accuracy among ultrasound physicians.

This retrospective study analyzed 17 cases of TM confirmed by histopathological examination at the First Affiliated Hospital of Soochow University from January 2015 to December 2024. Clinical characteristics were systematically documented, and ultrasound images were independently reviewed by two experienced radiologists. The study primarily assessed conventional and contrast-enhanced ultrasonographic features of TM.

Seventeen patients with pathologically confirmed TM were included. The primary tumors originated from lung cancer and esophageal cancer in 5 cases each (29.41%), laryngeal cancer in 3 (17.65%), and nasopharyngeal carcinoma, pancreatic cancer, thoracic chondrosarcoma, and breast cancer in 1 case each (5.88%). Clinically, rapid lesion enlargement within a short interval was observed in 7 patients (41.18%), dyspnea in 4 (23.53%), hoarseness in 10 (58.82%), and dysphagia in 8 (47.06%). Conventional ultrasound revealed unilateral lobe involvement in 14 patients (82.35%) and bilateral involvement in 3 (17.65%). Most lesions were nodular (88.24%, 15/17), hypoechoic (82.35%, 14/17), and characterized by ill-defined or irregular margins or extrathyroidal extension (88.24%, 15/17); 2 cases (11.76%) presented with a diffuse pattern. Cystic-solid composition was detected in 8 cases (47.06%), coarse calcifications in 4 (23.53%), and microcalcifications in 6 (35.29%). Among the 10 patients with complete CEUS data, 8 (80.00%) exhibited heterogeneous enhancement and 8 (80.00%) demonstrated perfusion defects. Enhancement intensity was equally divided between low enhancement and iso-/hyperenhancement (50.00% each).

TM exhibit distinct conventional ultrasound and CEUS features. When integrated with clinical history, multimodal ultrasound evaluation significantly enhances early detection and diagnostic accuracy of TM.