Objective To explore the application of the multislice spiral CT screening on small hepatocellular carcinoma in dual-phase enhanced scanning .Methods 36 patients with small hepatocellular carcinoma were collected from our department , every patient was examined using Plain and dual phase enhanced CT scan , all patients were confirmed by histopathology .We ana-lyzed the density and edge features of plain and dual phase enhanced CT scan , compared the detection rate of small hepatocellular carcinoma and the changes of different scanning phase of tumor and the liver density difference .Results The range of small hep-atocellular carcinoma was 2.0~1.3 cm, the lesion which showed circular low density in plain CT was 83.3%, equidensite was 16.7%, uniform density in enhanced CT scan accounted for 58.3%, tumor uneven density was 41.7%, boundary clearly in en-hanced CT scan accounted for 66.7%, fuzzy boundaries accounted for 33.3%;the detection rate of arterial phase was 91.7%, detection rate of portal venous phase was 80.6%, and detection rate of CT scan was 63.9%, the difference was statistically sig-nificant ( P <0.05);The difference between tumor and hepatic portal phase density was the biggest , the difference bewtween the scan period of tumor and the liver density was the minimum , the difference of the portal venous phase and arterial phase scan and was significant ( P <0.05).Conclusion Spiral CT of dual phase scan had high detection rate on small hepatocellular carcino-ma, which had accurate and reliable value .%目的：探讨多层螺旋CT双期增强扫描对原发性肝微小细胞癌的诊断价值。方法对36例肝微小细胞癌的患者，分别采用CT平扫及双期增强扫描对患者进行检查，所有患者均经病理组织证实；分析平扫和增强扫描病灶的密度和边缘表现，并对小肝癌检出率及不同扫描时相肿瘤与肝脏密度差值的变化情况进行比较。结果肝微小细胞癌的病灶范围在1．3～2．0cm之间。 CT平扫病灶呈类圆形低密度影者占83．3％，等密度者占16．7％，增强后瘤内密度均匀者占58．3％，瘤内密度不均匀占41．7％，增强后病灶边界清楚者占66．7％，边界模糊者占33．3％；动脉期的检出率为91.7％，门脉期的检出率为80．6％，而CT平扫的检出率为63．9％，差异具有统计学意义（ P ＜0．05）；门脉期肿瘤与肝脏密度的差值最大，而平扫期肿瘤与肝脏密度的差值最小，门脉期与动脉期及平扫的差值均有统计学意义（ P ＜0．05）。结论螺旋CT双期增强扫描对肝微小细胞癌的检出率高，诊断准确可靠，具有较高的诊断价值。
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