目的 分析增强CT瘤内动脉鉴 别肝内胆管细胞癌与低分化肝细胞癌 的临床价值。方法 回顾性分析2013年 6月-2015年6月于我院经病理证实为肝 内胆管癌(n=40)、低分化肝细胞癌患者 (n=50)的临床资料，所有患者均已接受 动态增强CT扫描且影像学资料完整，分 析增强CT扫描在鉴别肝内胆管细胞癌 与低分化肝细胞癌中的应用价值。结 果 ICC患者CT平扫及增强扫描以分叶征 (77.5%)、肝内胆管扩张(72.5%)、动 脉期肿瘤内肝动脉(47.5%)、环形强化 (57.5%)、延迟强化(60.0%)等征象多 见，所占比例均高于p-HCC患者，对比差 异有统计学意义(P＜0.05)。结论 肿瘤 内肝动脉、对比剂迅速廓清、分叶征、 肝内胆管扩张、动脉期环形强化、延迟 强化等征象均为鉴别肝内胆管细胞癌与 低分化肝细胞癌的重要CT征象，是两者 鉴别诊断的重要依据。

Objective To analyze the clinical value of enhanced CT of intratumoral artery in differential diagnosis of intrahepatic cholangiocarcinoma and poorly differentiated hepatocellular carcinoma. Methods The clinical data of patients with intrahepatic cholangiocarcinoma (n=40) and poorly differentiated hepatocellular carcinoma (n=50) confirmed by pathology in our hospital from June 2013 to June 2015 were retrospectively analyzed. All patients underwent dynamic contrast enhanced CT scan and the imaging data were complete. The application value of enhanced CT scan in differential diagnosis of intrahepatic cholangiocarcinoma and poorly differentiated hepatocellular carcinoma was analyzed. Results Most of the signs of CT plain scan and enhanced scan in patients with ICC were lobulation signs (77.5%), intrahepatic bile duct dilatation (72.5%), arterial phase intratumoral hepatic artery (47.5%), annular enhancement (57.5%) and delayed enhancement (60.0%). The proportions were higher than that of patients with p-HCC and the differences were statistically significant (P<0.05). Conclusion Intratumoral hepatic artery, rapid clearance of contrast medium, lobulation signs, intrahepatic bile duct dilatation, arterial phase annular enhancement and delayed enhancement etc. are important CT signs for differential diagnosis of intrahepatic cholangiocarcinoma and poorly differentiated hepatocellular carcinoma which are the important basis for the differential diagnosis of the two.