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目的 探讨肝脏神经内分泌肿瘤(NENs)与肝细胞癌(HCC)的CT表现特征的差异.方法 回顾性分析笔者所在医院于2011年6月至2016年6月期间收治的、经病理学检查证实的42例肝脏NENs患者和49例HCC患者的临床资料和CT影像学资料,按病灶直径是否≥3 cm进行分层,比较不同分层内的肝脏NENs患者和HCC患者的CT征象.结果 在肿瘤直径＜3 cm的患者中,肝脏NENs组和HCC组患者的病灶直径、病灶边界、假包膜情况、平扫密度、富血供情况、动脉期强化程度、动脉期强化方式、肝内子灶、肝包膜凹陷、肿瘤新生动脉、动静脉受侵、门静脉癌栓、淋巴结直径及淋巴结强化程度比较差异均无统计学意义(P＞0.05),但2组患者的病灶位置、病灶形状及门静脉期强化方式比较差异均有统计学意义(P＜0.05),与HCC组比较,肝脏NENs组患者的病灶多位于全肝,病灶形状多呈类圆形,门静脉期强化方式多为持续强化.在肿瘤直径≥3 cm的患者中,肝脏NENs组和HCC组患者的病灶直径、病灶边界、平扫密度、富血供情况、动脉期强化程度、动脉期强化方式、肝内子灶、肝包膜凹陷、门静脉癌栓、淋巴结直径及淋巴结强化程度比较差异均无统计学意义(P＞0.05),但2组患者的病灶位置、假包膜情况、病灶形状、门静脉期强化方式、肿瘤新生动脉及动静脉受侵情况比较差异均有统计学意义(P＜0.05),与HCC组比较,肝脏NENs组患者的病灶多位于全肝,多无假包膜形成,多呈分叶状,门静脉期强化多呈持续强化,肿瘤多无新生动脉形成,且动静脉多未受侵.结论 无论病灶直径是否≥3 cm,肿瘤位置、病灶形状及门静脉期强化方式均有助于鉴别肝脏NENs与HCC.当病灶直径≥3 cm时,肿瘤假包膜、肿瘤内新生动脉、动静脉受侵犯等有助于鉴别肝脏NENs与HCC.“,”Objective To discuss the CT imaging differences between hepatic neuroendocrine neoplasms (NENs) and hepatocellular carcinoma (HCC).Methods The clinical and CT data of 42 patients with hepatic NENs (hepatic NENs group) and 49 patients with HCC (HCC group),who were confirmed by pathology in the West China Hospital of Sichuan University from June 2011 to June 2016,were collected and analyzed retrospectively.This study was based on whether the lesions were larger than 3 cm or not,then CT findings of hepatic NENs patients and HCC patients in different stratification were compared.Results When the lesions were less than 3 cm,the location,contour,and enhancement patterns in the portal vein phase of the tumor had significant differences between the hepatic NENs group and the HCC group (P＜0.05),multiple liver lesions,the round shape,and prolonged enhancement in the portal vein phase were more often seen in the hepatic NENs group,but there was no significant on diameter of tumor,boundary of lesion,pseudocapsules,scan density,hypervascularity,enhancement degree in arterial phase,enhancement patterns in arterial phase,daughter foci at liver,retraction,neoplastic artery,arteriovenous invaded,portal vein tumor thrombus,diameter of lymph node,and enhancement degree of lymph node between the 2 groups (P＞0.05).And when the lesions were greater than or equal to 3 cm,the location,contour,enhancement patterns in the portal vein phase of the tumor,pseudocapsule,neoplastic artery,and arteriovenous invaded had significant differences between the hepatic NENs group and the HCC group (P＜0.05),these CT images were often seen in the hepatic NENs group,such as multiple liver lesions,the lobulated shape,the portal venous phase continuous strengthening,no pseudocapsule,no neoplastic artery,and no arteriovenous invaded,but there was no significant difference on the diameter of tumor,boundary of lesion,scan density,hypervascularity,enhancement degree in arterial phase,enhancement patterns in arterial phase,daughter foci at liver,retraction,portal vein tumor thrombus,diameter of lymph node,and enhancement degree of lymph node between the 2 groups (P＞0.05).Conclusions No matter whether the lesions' size are larger than 3 cm or not,the location,contour,and enhancement patterns in the portal vein phase could help for differentiating hepatic NENs from HCC.When the lessions are larger than 3 cm,pseudocapsule,neoplastic artery,and arteriovenous invaded may be useful to differentiate.