Objective: The aim of this study was to investigate progression of hepatic hyperperfusion disorders revealed dur-ing fol ow-up contrast material-enhanced multi-slice spiral computed tomography (MSCT) scan of digestive system neoplasm. Methods: Three-phase contrast material-enhanced MSCT were performed during the fol ow-up in patients with digestive system malignant tumor confirmed histological y. The progression of hepatic hyperperfusion disorders revealed on contrast material-enhanced CT image were investigated at the 2 years fol ow-up with approximately 6 months interval. Results: The hepatic hyperperfusion disorders were showed in 39 patients on fol ow-up contrast material-enhanced MSCT scans. Among the 39 patients, initial hyperperfusion disorders were revealed in 6 (15.38%), 26 (66.67%), and 7 (17.95%) patients in 6, 12, and 18 months during fol ow-up respectively. The initial hyperperfusion disorders revealed in 12 months were more frequent than those revealed in 6 months (χ2 = 14.82, P < 0.05) and 18 months (χ2 = 15.02, P < 0.05). Among the 39 patients, the hyperperfusion disorders progressed into liver metastasis based on typical CT findings in 37 (94.87%) patients, and were not obvious changes in 2 (5.13%) patients. Among the 37 patients, the hyperperfusion disorders progressed into metastasis in 10 (25.64%) patients in 6 months after the hyperperfusion disorders were revealed, and in 27(69.23%) patients in 12 months. The hyperperfusion disorders developing into metastasis were more in 12 months than those in 6 months (χ2= 14.98, P < 0.05). Conclusion: Most hepatic hyperperfusion disorders revealed at the fol ow-up of digestive system neoplasm may be early manifestations of liver metastasis. The careful fol ow-up of hepatic hyperperfusion disorders is necessary.