目的探讨肝细胞癌患者CT表现 及对病理分级的诊断价值。方法 选取 2016年9月至2017年9月在我院诊治的肝 细胞癌并进行部分肝切除术患者500例， 术前进行CT增强扫描，观察CT扫描供血 分型及CT征象中肿瘤大小、门静脉或肝 静脉癌栓、肿瘤内坏死、肝硬化、淋巴 结肿大等情况，并将CT检查结果与术后 病理结果进行对比，分析CT检查结果与 病理分级关系。结果 本研究500例肝细 胞癌患者，肝细胞癌患供血分型为：肝 动脉型317例(63.40%)、肝动脉和门静脉 双重供血型126例(25.20%)、少血供型57 例(11.40%)、门静脉供血型0例。CT扫描 肿瘤大小、门静脉或肝静脉癌栓，与手 术病理结果比较，差异无统计学意义(P ＞0.05)；CT扫描肿瘤内坏死、肝硬化、 淋巴结肿大，与手术病理结果比较，差 异有统计学意义(P＜0.05)。病理分级 Ⅰ、Ⅱ级70例(62.50%)，Ⅲ、Ⅳ级42例 (37.50%)，其中CT显示肿瘤范围越大、边 缘清楚、有肿瘤内出血坏死、有侵袭转移 者，肿瘤分级均较高，差异有统计学意义 (P＜0.05)。结论 肝细胞癌患者CT表现能 为病理分级提供客观参考依据，有一定的 诊断价值。

Objective To explore the CT findings and their diagnostic value of pathological grading in patients with hepatocellular carcinoma. Methods A total of 500 cases of patients who diagnosed as hepatocellular carcinoma and treated with partial hepatectomy in our hospital from September 2016 to September 2017 were selected, and they were given CT enhanced scan before operation. The blood supply types of CT scan and the CT signs of tumor size, portal vein or hepatic vein tumor thrombus, necrosis in the tumor, liver cirrhosis and lymphadenopathy were observed. The CT findings were compared with postoperative pathological results, and the relationship between CT findings and pathological grading was analyzed. Results Among 500 patients with hepatocellular carcinoma in this study, 317 cases (63.40%) were hepatic artery type, 126 cases (25.20%) were dual blood supply type of hepatic artery and portal vein, and 57 cases (11.40%) were less blood supply type and 0 case was portal vein blood supply. There were no statistically significant differences in tumor size, portal vein or hepatic vein tumor embolus of CT scan compared with those of surgical pathology results (P>0.05). There were statistical significant differences in the necrosis in the tumor, liver cirrhosis and lymphadenopathy of CT scan compared with those of surgical pathology results (P<0.05). There were 70 cases (62.50%) in pathological grades I and II and 42 cases (37.50%) in grades III and IV. CT showed that the larger cancer cells, the clearer edges, hemorrhage and necrosis in the tumor, and invasion and metastasis all resulted in a higher tumor grade (P<0.05). Conclusion CT findings of patients with hepatocellular carcinoma can provide an objective reference for pathological grading, and it has a certain diagnostic value.