目的研究低剂量64层螺旋CT 扫描和超声造影诊断对小肝癌 ( S m a l l hepatic carcinoma,SHCC)的临床诊断价 值。方法 研究年限为2012年12月-2014 年12月，对象为38例经门诊和住院部收 治的超声检查提示为肝脏发生占位性病 变的患者，所有患者均接受超声造影检 查(A组)、低剂量64层螺旋CT双动脉期 多期扫描(B组)和两种联合检查(C组)。 对三组患者的诊断结果进行对照。结 果 A组检查的灵敏性(81.85%)、特异性 (78.95%)、准确率(76.32%)；B组检查的 灵敏性(78.95%)、特异性(84.21%)、准 确率(73.68%)；组间比较*P、**P、#P均 ＞0.05，无显著差异。C组检查的灵敏性 (98.24%)、特异性(100.00%)、准确率 (94.74%)；分别与A组和B组比较，*P、 **P、#P＜0.05，统计学差异显著。B组检 查中SHCC病灶主要表现为典型的“快进快 出”强化征象，误诊率为2.63%。A组检查 中误诊率为5.26%。结论 64层螺旋CT双动 脉期多期扫描联合超声造影对SHCC的诊断 均具有较高的准确率、灵敏性和特异性， 其能够对缺乏血供、不典型的SHCC肝癌进 行准确诊断，建议在临床诊断中优先选择 使用。

Objective This paper is to investigate clinical diagnosis value of low dose of 64–slice spiral CT scanning and contrast-enhanced ultrasonically in the diagnosis of Small hepatic carcinoma. Methods The years of research extended from December, 2012 to December, 2014, and research subjects were 38 patients admitted by the outpatient clinic and the inpatient department were indicated to suffer from liver space-occupying lesions via ultrasonic examination, 19 patients in the control group were subject to low dose of 64-slice spiral CT multi-phase scanning, and 19 patients in the experiment group were subject to contrast-enhanced ultrasonically. Diagnosis results of patients in two groups were compared on the basis of clinically pathological diagnosis. Results The sensitivity (100.00%) and accuracy (94.74%) of CT examination were higher than those of ultrasound examination (96.63% and 94.44%), but the specificity (98.24%) of CT examination was lower than that of ultrasound examination (100.00%).The intergroup comparison satisfied P>0.05,and there is no significant difference. Medium and small unicellular carcinoma lesions in CT examination mainly manifested enhanced sign of typical "Fast-out and Fast-in" with misdiagnosis rate ar 5.26%. Conclusion Diagnosis of 64 slice spiral CT scan combined with double arterial phase of contrast-enhanced ultrasound on SHCC has higher accuracy, sensitivity and specificity, which can lack of blood supply, not the typical SHCC unicellular carcinoma by accurate diagnosis, to recommend the preferred option for use in clinical diagnosis.