目的 分析多层CT灌注技术对肝 肿瘤病变鉴别的临床价值。方法 以我院 2013年5月-2015年5月就诊的40例肝脏疾 病患者为研究对象，病理学检查证实良 性病变22例，恶性病变18例，选择同期 健康体检人员20例为正常对照组，均接 受320排CT灌注扫描，比较各组肝脏组织 CT灌注成像参数。结果 肝囊肿各灌注参 数均为0。肝血管瘤、肝癌患者与正常对 照组在BF、MTT、HPI、HAP方面比较差异 有统计学意义(P＜0.05)。肝血管瘤BF、 BV、PVP明显高于肝癌(P＜0.05)。肝癌 HAP上明显不均匀高灌注，部分坏死区低 灌注，边缘明显比中心坏死区灌注高； PVP上明显不均匀低灌注，大部分病灶和 周边肝实质间分界不明显。肝血管瘤HAP 上边缘结节性强化区明显高灌注，早期 无强化区低灌注；PVP上灌注区部分低灌 注，早期无强化区低灌注。结论 320排 CT灌注成像各参数对肝脏肿瘤血流状态 反映，对肿瘤良恶性判断有重要作用。

Objective To analyze the clinical value of multi-slice CT perfusion technique in the differential diagnosis of liver neoplasm lesions. Methods 40 patients with liver diseases treated in our hospital from May 2013 to May 2015 were taken as the research objects. Pathological examination confirmed that 22 cases were with benign lesions and 18 cases with malignant lesions. 20 cases of healthy persons who received physical examination in the same period were selected as the normal control group. All of them received 320 slice CT perfusion scan. CT perfusion imaging parameters of liver tissues in each group were compared. Results The perfusion parameters of liver cysts were 0. The differences in BF, MTT, HPI and HAP between patients with hepatic hemangioma and liver cancer and the normal control group were statistically significant (P<0.05). BF, BV and PVP of patients with hepatic hemangioma were significantly higher than those of patients with liver cancer (P<0.05). There was significant inhomogeneous high perfusion on liver cancer HAP, with low perfusion in some of the necrotic areas. The perfusion of edges was significantly higher than that of the central necrotic areas; There was significant inhomogeneous low perfusion on PVP, with unconspicuous boundaries between most of the lesions and the surrounding liver parenchyma. There was significant high perfusion in nodular enhanced areas on the upper edge of hepatic hemangioma HAP and low perfusion in early areas without enhancement. In PVP upper perfusion region, there was some low perfusion and low perfusion in early areas without enhancement. Conclusion 320 slice CT perfusion imaging parameters can reflect the blood flow state of liver neoplasm and plays an important role in judging the benign and malignant tumors.