目的评价320排CT和CT血管造影(CTA)三维辅助成像技术在肝癌诊断中的应用价值。方法回顾性分析41例合并门静脉癌栓(PVTT)的肝癌患者在介入治疗前分别行肝脏320排CT和16排CT的CTA影像资料,比较两种CT在显示肝内瘤灶、PVTT、动静脉瘘(AVF)和肝动脉起源走行等方面的差异。结果以数字减影血管造影(DSA)为参照,41例PVTT患者中应用320排CT诊断瘤灶39例,明显优于16排CT诊断的32例;320排CT和16排CT诊断瘤灶的灵敏度分别为97.6%和92.7%,诊断AVF的准确度分别为97.1%和85.4%;两者对肝动脉起源走行和解剖变异的显示基本一致。结论 320排CT和CTA除了具备16排CT的优点外,还能以更高的图像质量完成对肿瘤及肝脏血管的四维成像,诊断原发性肝癌更快速、准确,对介入治疗更具指导意义。 Objective To evaluate the value of 320-slice CT and CT angiography (CTA) three-dimensional imaging in the diagnosis of liver cancer. Methods A retrospective analysis of 41 cases of hepatocellular carcinoma with portal vein tumor thrombus (PVTT) before the interventional treatment were performed with CTA images of 320-slice CT and 16-slice CT of the liver. Comparisons of CT scan data of two kinds of CT in displaying intrahepatic tumor, PVTT, arteriovenous Fistula (AVF) and the origin of hepatic artery and other aspects of the difference. Results According to digital subtraction angiography (DSA), 41 cases of PVTT were diagnosed by 320-slice CT, which was significantly better than 32 cases diagnosed by 16-slice CT. The diagnosis of tumor by 320-slice CT and 16-slice CT The sensitivity was 97.6% and 92.7%, respectively, and the accuracy of diagnosis of AVF was 97.1% and 85.4% respectively. Both of them showed the same trend of the origin and anatomic variation of hepatic artery. Conclusion In addition to the advantages of 16-slice CT, the 320-slice CT and CTA can complete the four-dimensional imaging of tumor and liver vessels with higher image quality, which makes diagnosis of primary liver cancer more rapid and accurate and more instructive for interventional therapy .