目的研究64层螺旋CT对肝癌及 肝脏局灶性结节增生(FNH)的鉴别效果。 方法 对我院28例FNH者与24例肝癌患者 为研究对象，均采取64层螺旋CT检测， 扫描获得动脉期能谱系列图像及门静脉 期能谱系列图像，并计算病灶-肝脏对比 噪声比(CNR)、标准化碘浓度(NIC)、病 灶与周围肝组织碘浓度(LNR)。结果 动 脉期肝癌患者CNR显著低于FNH者，比较 组间比较均有统计学意义(P＜0.05)，动 脉期40-50keV呈上升趋势，后随能量上 升逐渐降低，而门静脉期肝癌患者40- 70keV呈上升趋势，后大体为降低趋势， 而FNH上升期仅为的40-50keV，50-90keV 降低，后又呈增加趋势；肝癌组动脉期 及门静脉期NIC、LNR显著低于FNH组，对 比差异显著(P＜0.05)。结论 64层螺旋 CT在肝癌及肝脏局灶性结节增生鉴别中 具有重要的临床意义，具有较高的临床 价值。

Objective To study the identification effect of 64 slice spiral CT on hepatic carcinoma and hepatic focal nodular hyperplasia (FNH). Methods 28 cases of patients with FNH and 24 cases of hepatic carcinoma were taken as the research object. All of the patients received 64 slice spiral CT detection to get energy spectrum series of images in arterial phase and portal vein phase and the carrier noise ratio(CNR) between lesions and liver, normalized iodine concentration (NIC), the NIC of lesions and the surrounding tissues (LNR) of liver were calculated. Results In the arterial phase, CNR of patients with hepatic carcinoma was significantly lower than that of patients with FNH and the comparison between groups was statistically significant (P<0.05). 40-50keV showed a rising trend and then decrease with the increase of energy while in portal vein phase, 40- 70keV in patients with hepatic carcinoma showed a rising trend, then showed a decreased trend and increase period of FNH leading to 40-50keV. 50-90keV decreased and then showed an increasing trend; NIC and LNR of the hepatic carcinoma (HCC) group in arterial phase and portal vein phase were significantly lower than those of FNH group and the difference was significant (P<0.05). Conclusion 64 slice spiral CT is of important clinical significance in the differentiation of hepatic carcinoma and hepatic focal nodular hyperplasia,which is of high clinical value.