目的分析小肝癌在螺旋CT三期(动脉期、门脉期和延迟期)增强扫描的表现,比较各期的病灶检出率,提高小肝癌的诊断水平。方法46例小肝癌分别行多层螺旋CT平扫及三期增强扫描,扫描时间分别为动脉期25s、门脉期70s、延迟期5min,用高压注射器经肘静脉推注,速率为3ml/s,剂量为1.5ml/kg。结果46个病灶中,35个病灶呈典型增强形式,即动脉期呈高密度(均匀或不均匀),门脉期迅速变为低或等密度,延迟期仍呈低密度。11个病灶呈不典型表现,其中3个病灶动脉期和门脉期均呈高密度,延迟期则均呈等密度;4个病灶在动脉期、门脉期和延迟期中均呈低密度;4个病灶在动脉期呈等密度,而其它各期为低密度。结论大多数的SHCC在三期扫描上呈典型表现。SHCC定性诊断主要靠增强的动态变化特点,综合三期扫描的表现可提高诊断与鉴别诊断能力。 Objective To analyze the performance of small hepatocellular carcinoma in enhanced CT in the third phase of spiral CT (arterial phase, portal phase and delayed phase) and to compare the detection rate of each phase and improve the diagnosis of small hepatocellular carcinoma. Methods Forty-six patients with small hepatocellular carcinoma were scanned with multi-slice spiral CT and enhanced phase III respectively. The scanning time was 25s, the portal vein period was 70s, the delay period was 5min. The high-pressure syringe was injected through the elbow vein at a rate of 3ml / s , The dose is 1.5ml / kg. Results Among the 46 lesions, 35 lesions showed typical enhancement, that is, the arterial phase showed high density (uniform or non-uniform), the portal phase rapidly became low or isodense, and the delay period was still low. Eleven lesions were atypical, of which three lesions showed high density in the arterial and portal phases and an equal density in the delayed phases. Four lesions showed low density in the arterial phase, portal phase and delayed phase. 4 The lesions showed equal density in the arterial phase and low density in other phases. Conclusions Most of the SHCCs show typical features in three stages of scanning. The qualitative diagnosis of SHCC mainly depends on the characteristics of dynamic changes. The comprehensive three-phase scan can improve the ability of diagnosis and differential diagnosis.