目的 探讨多层螺旋CT增强扫描 在诊断肝脏占位性病变的临床价值。方 法 回顾性分析2013年10月至2015年10月 35例(48个病灶)肝占位性病变患者的CT平 扫及增强扫描的影像资料，并与临床病 理比较。结果 以临床病理检查作为“金 标准”，CT平扫诊断肝脏占位性病变的准 确性为60.42%，敏感性59.26%，特异性 61.90%；CT增强扫描诊断肝脏占位性病变 的准确性为93.75%，敏感性92.59%，特 异性95.24%，两组比较差异有统计学意 义(P＜0.05)。CT增强扫描诊断肝癌的的 准确率为92.59%高于CT平扫的59.26%(P ＜0.05)。CT平扫显示为肝内小结节状稍 低密度影，无清晰边缘；动脉期扫描病灶 呈结节性、边缘性强化，部分病变轮廓清 楚显示；门脉期扫描病灶强化程度减低。 肝囊肿、肝腺瘤、局灶性结节增生、肝血 管瘤病因例数过少，未进行统计学分析。 结论 螺旋CT增强扫描可提高肝脏占位性 病变检出率，可为临床确定治疗方案提供 丰富信息。

Objective To investigate the clinical value of multi-slice spiral CT enhanced scanning in the diagnosis of liver space occupying lesions. Methods The imaging data of CT plain scan and enhanced scan of 35 patients (48 lesions) from October 2013 and January 2015 were analyzed retrospectively and were compared with clinical pathology. Results With the clinical pathological examination as the golden standard, the accuracy, sensitivity and specificity of CT plain scan in the diagnosis of liver space occupying lesions were 60.42%, 59.26% and 61.90% respectively, while those of CT enhanced scanning were 93.75%, 92.59% and 95.24%, respectively(P＜0.05). The accuracy of CT enhanced scanning in the diagnosis of liver cancer (92.59%) was higher than that of CT plain scan (59.26%) (P＜0.05). CT plain scan showed small nodule like slightly low density shadow in the liver, without clear edges. The arterial phase scan showed nodular lesions, peripheral enhancement, and some lesions with clear outlines. The portal phase showed that the lesion enhancement decreased. Since there were few cases with liver cyst, liver adenoma or focal nodular hyperplasia, the cases were not analyzed statistically. Conclusion Spiral CT enhanced scanning can improve the detection rate of liver space occupying lesions, which can provide abundant information for clinical treatment.