目的研究CT能谱多参数成像 对肝癌和肝局灶性结节增生(FNH)的鉴 别价值。方法 选取2012年6月至2014年 8月在我院行肝脏能谱CT扫描的患者， 对肝癌和FNH患者的能谱定量参数进行 分析。结果 肝癌与FNH动脉期能谱CT 值衰减曲线斜率分别为(1.81±0.51) 和(4.01±0.54)，门静脉期分别为 (2.82±0.49)和(4.07±0.59)，两期肝癌 与FNH相应能谱CT衰减曲线斜率差异有统 计学意义(p＜0.05)；动脉期肝癌和FNH 在50keV下CNR(对比度噪声比，contrast to noise ratio)最佳，门静脉期肝癌在 70keV下具有最佳的CNR，FNH在40keV下具 有最佳的CNR；动脉期ICRLN所对应的ROC 曲线下面积最大，其次为门静脉期NIC， 最低为门静脉期ICRLN，动脉期ICRLN参考 值4.175，鉴别肝癌和FNH的灵敏度和特异 度均达到100%。结论 CT能谱多参数成像 在鉴别肝癌和FNH中有较高的诊断价值， 能提高诊断的准确性。

Objective Analyze the clinical value of CT Spectral multi-parameter imaging in identification of hepatocellular carcinoma(HCC) and focal nodular hyperplasia of the liver(FNH). Methods The CT spectral data of HCC and FNH of 44 cases from June 2012 to August 2014 in our hospital were collected and analyzed. Results The CT attenuation curve slope at arterial phase of HCC and FNH were (1.81±0.51 and (4.01±0.54), portal venous phase were (2.82±0.49) and (4.07±0.59), the energy spectrum CT attenuation curve slope between HCC and FNH is significant difference (P<0.05); In arterial phase, HCC and FNH has the best CNR at 50 keV, and portal venous phase, HCC has the best CNR at 70keV, FNH has the best CNR at 40keV; ROC curve maximum area corresponding to the arterial phase ICRLN, followed by portal venous phase NIC, the lowest for the portal venous phase ICRLN, the arterial phase ICRLN reference value was 4.175, sensitivity and specificity of differentiating hepatocellular carcinoma and FNH reached 100%. Conclusion The diagnostic value of CT multi-parameter imaging in differentiating HCC adn FNH is higher than normal CT, which can improve the accuracy of diagnosis.