Objective To investigate the diagnostic value of dual-phase contrast enhanced multi-slice spiral CT and plain CT in the diagnosis of small cell carcinoma of the liver. Methods 118 patients with small cell hepatocellular carcinoma were randomly divided into observation group (59 cases) and control group (59 cases) according to different examination methods. The patients in the observation group underwent multi-slice spiral CT dual-phase enhanced scanning. The control group underwent CT plain scan. The diagnostic rate of small cell hepatocellular carcinoma, the density and image manifestation of the lesions on CT scanning, and the difference of the density between the tumors and the liver in different scanning phases were compared between the two groups. Results The diagnosis rate of hepatocellular carcinoma in observation group was significantly higher than that in control group. In the observation group, there were 34 cases with homogeneous tumor density in the group of hepatocellular carcinoma, accounting for 57.6％. There were 25 cases with uneven tumor density in the observation group, accounting for 42.4％; 40 cases with clear lesions borderline, accounting for 67.8％ There were 19 cases of blurred patients with lesions border, accounting for 32.2％. In the control group, there were 47 patients with low density of small cell carcinoma in the control group, accouting for 79.7％, 12 cases with high density shadow, accounting for 20.3％, 45 cases with uniform tumor density, accounting for 76.3％ There were 14 patients with uneven internal density, accounting for 23.7％. Twenty-two patients (37.3％) had clear boundary of lesions, 37 patients had blurred border of lesions, accounting for 62.7％. There were significant differences between the observation group in the arterial phase, portal phase and control group in tumor and liver density differences, of which the difference between portal vein phase tumor and liver density in the observation group was the largest, and the difference between tumor and liver density in the control group was the smallest. Conclusion MSCT double-phase enhanced scan in the diagnosis of small cell lung cancer diagnosis rate is high, with high clinical value.%目的 探讨多层螺旋CT双期增强扫描与CT平扫在肝小细胞癌中的诊断价值.方法 将118例肝小细胞癌患者作为研究对象,并将其按照检查方法的不同随机分成观察组59例与对照组59例,观察组患者行多层螺旋CT双期增强扫描检查,对照组患者行CT平扫检查,分别对两组患者的肝小细胞癌确诊率、CT扫描时病灶的密度及图像表现、不同扫描时相肿瘤与肝脏密度差值的变化情况进行对比.结果 观察组肝小细胞癌患者的确诊率要明显高于对照组患者.观察组肝小细胞癌患者中瘤内密度均匀患者34例、占57.6％,有瘤内密度不均匀患者25例、占42.4％;病灶边界显示清楚患者40例、占67.8％,病灶边界显示模糊患者19例、占32.2％.对照组肝小细胞癌患者中低密度影患者47例、占79.7％,高密度影患者12例、占20.3％,瘤内密度均匀患者45例、占76.3％,瘤内密度不均匀患者14例、占23.7％,病灶边界显示清楚患者22例、占37.3％,病灶边界显示模糊患者37例、占62.7％.观察组动脉期、门脉期及对照组患者的肿瘤与肝脏密度差值均存在明显差异,其中观察组门脉期肿瘤与肝脏密度差值最大,对照组肿瘤与肝脏密度差值最小.结论 多层螺旋CT双期增强扫描在肝小细胞癌诊断中的确诊率较高,具有较高的临床应用价值.
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