目的 旨在探讨螺旋CT三期动态 扫描与平扫在肝癌诊断中的应用价值。 方法 选取我院经病理学检查证实的78例 肝癌患者作为研究对象，分析肝癌在CT平 扫及三期增强扫描中的影像表现特征， 比较两中检查对病灶的检出率。结果 78 例患者中单发病灶者72例(93.58%)，多 发患者5例(6.41%)，共89个病灶。76例 (97.43%)患者CT平扫显示为低密度或等密 度影，外观形态多呈现圆形或类圆形影； CT三期扫描结果显示，64例(82.05%)患者 动脉期病灶快速增强，以高或等密度，呈 点状、结节状或云絮状显著强化，病灶随 时间强化持续存在且向中央扩散，其中 48例(61.53%)为表现为均匀强化，16例 (20.51%)为中强化，12例(15.38%)患者未 见未强化，2例(2.56%)为不均匀强化；61 例(78.20%)患者门脉期病灶密度迅速降 低，低于肝实质密度；延迟期呈低密度 改变，呈现典型的“快进快出”的影像 学表现；CT平扫对肝癌病灶的检出率为 83.14%(74/89)，三期综合增强扫描对肝 癌病灶的检出率为100%(89/89)，CT平扫 对肝癌病灶的检出率明显低于三期增强综 合扫描(P<0.001)。结论 螺旋CT三期动态 扫描对肝癌的检出率高，可清楚显示肝癌 典型的图像特征，为临床制定治疗方案提 供可靠影像学资料。

Objective To investigate the value of spiral CT threephase dynamic scan and plain scan in the diagnosis of liver cancer. Methods 78 cases of liver cancer confirmed by pathology in 9 menstrual cycles in our hospital were selected as the subjects, to analyze the imaging features of liver cancer during CT noncontrast enhanced scan and three phase enhanced scan, compare the detection rate of the lesions between the two examinations. Results Of the 78 patients, 72 cases were solitary lesions (93.58%), multiple lesions were in 5 cases (6.41%), there were 89 lesions. In 76 patients (97.43%), CT noncontrast enhanced scan showed low density or equal density shadow,the appearance of the shape of a circular or circular shadow. CT phasethree scan results show, in 64 patients (82.05%), the arterial phase lesions increased rapidly, marked by high or equal density, punctate, nodular or flocculent, the lesion persisted with time and diffused toward the center, 48 of them (61.53%) showed homogeneous enhancement, 16 cases (20.51%) were moderately strengthened. 12 patients (15.38%) showed no enhancement, 2 cases (2.56%) were inhomogeneous enhancement. In 61 patients (78.20%), the density of the portal phase decreased rapidly, lower than parenchymal density. The delayed phase showed low density change, presenting typical "fast forward, fast out" imaging findings,The detection rate of CT noncontrast enhanced scan for HCC was 83.14% (74/89), the detection rate of HCC in the three phase enhanced scan was 100% (89/89), the detection rate of CT noncontrast enhanced scan for liver cancer lesions was significantly lower than that of phase three enhanced integrated scan (P<0.001). Conclusion The three phase dynamic scan of spiral CT has high detection rate for liver cancer, which can clearly show the typical image features of liver cancer, and provide reliable imaging data for clinical treatment.