目的通过多层螺旋CT灌注参数 分析肝癌结节的血液动力学变化，并对 其诊断价值作出评价。方法 收集2011年 1月-2014年6月期间来我院肝胆外科就诊 的患者110例作为研究对象。原发性肝癌 患者60例作为观察组，另取健康者50名作 为对照组，对所有研究对象进行CT灌注成 像及增强扫描，分析对照组正常肝实质、 肝癌结节组及癌周肝实质组间的肝血流量 (HBF)、肝血容积(HBV)、肝动脉灌注量 (HAP)、肝动脉指数(HAI)等参数。结果 三组间的HBF、HBV、HAP、HAI、HPP、MTT 及PS均存在显著性差异性(P<0.05)。肝癌 结节组HBF、HAI、MTT及HAP高于对照组肝 实质，PS低于对照组肝实质，差异具统计 学意义(P<0.05)，HBV与HPP与对照组肝实 质相比未见显著性差异(P>0.05)；肝癌结 节组HBF、HAP、HAI、MTT及HPP高于癌周 肝实质组，差异具统计学意义(P<0.05)， HBV及PS与癌周肝实质组相比差异不具 统计学意义(P>0.05)；癌周肝实质组的 HAP、PS、MTT及HPP与对照组相比差异性 显著(P<0.05)，HBF、HBV与HAI与对照组 间差异不具统计学意义(P>0.05)。结论 多层螺旋CT成像技术在肝癌结节的血液动 力学变化检测方面良好的分辨力，能有效 鉴别出不同性质组织间的血液灌注差异， 提高了对肝癌结节进行影像学诊断的敏感 性与特异性。

Objective To analyze the hemodynamic changes by multi-slice spiral CT perfusion parameters of liver nodules, and to evaluate its diagnostic value. Methods 110 patients who were admitted in our liver and gall surgical department from January 2011 to June 2014 were selected as research objects. 60 cases with primary liver cancer were observation group, and 50 healthy person were control group. All subjects underwent CT perfusion scanning and enhanced scanning. The parameters includs HBF, HBV, HAP, HAI, HPP, MTT, and PS, and the differences were analyzed. Results There were no significant differences in HBF, HBV, HAP, HAI, HPP, MTT, and PS among the three groups (P <0.05). HBF, HAI, MTT, and HAP of HCC nodules group were higher than the control group, and PS was lower than the control group(P<0.05). HBV and HPP had no significant difference between HCC nodules group and the control group(P> 0.05); HBF, HAP, HAI, MTT, and HPP of HCC nodules group were higher than peritumor group, and the difference was statistically significant (P<0.05); HBV and PS had no significant difference between HCC nodules group and peritumor group(P> 0.05). HAP, PS, MTT, and HPP had significant difference (P<0.05) and HBF, HBV, and HAI had no significant difference(P>0.05) between peritumor group and the control group. Conclusion Multi-slice CT has well resolution in the detection of blood dynamic changes of liver nodules, which can effectively identify different types of tissue perfusion and improve the sensitivity and specificity of the imaging diagnosis of liver nodules.