目的 分析小肝细胞癌的不典型CT表现，以提高对不典型小肝细胞癌的诊断准确率。方法 回顾性分析我院2010年 1月至2016年11月经病理证实的不典型小肝细胞癌18例，均行CT平扫及动态增强扫描。结果 所有病例均为单发病 灶，其CT表现形式分为以下11种：1)平扫低密度-动脉期高密度-门脉期高密度的5例。2)平扫低密度-动脉期高密度 （接近同层主动脉)-门脉期低密度的2例。3)平扫低密度-动脉期高密度-门脉期等密度的1例。4)平扫低密度-动脉 期边缘环形高密度、环不完整见壁结节-门脉期环及结节呈低密度的2例。5)平扫低密度-动脉期边缘环形高密度、 环不完整见结节-门脉期环及结节呈高密度的1例。6)平扫低密度-动脉期低密度-门脉期低密度的2例。7)平扫低密 度-动脉期低密度-门脉期等密度的1例。8)平扫低密度-动脉期等密度-门脉期呈低密度的1例。9)平扫等密度-动脉 期低密度-门脉期低密度的1例。10)平扫等密度-动脉期高密度-门脉期等密度的1例。11)平扫高密度-动脉期高密 度-门脉期高密度的1例。以上动脉期高密度未做接近同层主动脉标记的均为低于同层主动脉、高于肝脏密度。结论 小肝细胞癌的动态增强CT扫描有多种不典型的强化表现，正确认识这些不典型的强化表现，可以减少误诊率。

Objective To analyze the atypical CT findings of small hepatocellular carcinoma, so as to improve the accuracy of diagnosis. Methods A retrospective analysis was performed on 18 cases of atypical small hepatocellular carcinoma that were pathologically confirmed between January 2010 and November 2016 in our hospital. Results All the cases were single lesions, and the CT manifestations were divided into the following 11 types: 1) 5 cases of low density-arterial phase high density-portal phase high density. 2) two cases of low density-arterial high density (close to the same level of aorta)-portal low density. 3) 1 case with low density - arterial phase high density - portal phase equal density. 4) 2 cases with low density at the edge of arterial stage and low density at the edge of plain scanning, with incomplete ring. 5) 1 case with low density - arterial edge annular density, incomplete ring, nodular-portal ring and nodular density. 6) two cases of low density - arterial low density-portal low density were swept. 7) 1 case with low density-arterial phase low density-portal phase equal density. 8) 1 case presented low density in the scanning low-arterial isopyme-portal period. 9) one case of isodensity-low density in arterial phase - low density in portal phase. 10) one case of isodensityarterial density-portal density. 11) 1 case with histological density - arterial density-portal density. The higher arterial density was lower than that of the same aorta and higher than that of the liver. Conclusion The dynamic enhanced CT scan of small hepatocellular carcinoma has a variety of atypical enhanced manifestations, and the correct recognition of these atypical enhanced manifestations can reduce the misdiagnosis rate.