目的 :探讨小肝癌的回声特性与病理改变及组织学分型的关系。方法 :对超声检出的 6 5例小肝癌 (≤3.0cm)的回声特性与其术后病理组织学改变和病理分型进行对比分析。结果 :超声检出的小肝癌以低回声型最多见 ,高回声型次之。随着癌结节的增大 ,低回声型递减 ,高回声型渐增 ;脂肪变性或假腺样改变在高回声型中的比率较大 ,但是同样的病理改变也可以出现在低回声型中。在小肝癌的组织分型中 ,含有腔隙结构 (血窦或腺管样扩张 )的管外型和假腺型可见于强弱不同的回声型中 ,不含和很少含有血窦的硬化型和紧密型 ,则集中于低回声型中。瘤内血管增生则以等回声型最多见。结论 :小肝癌回声强弱主要与病理改变中的脂肪变性或假腺样改变和组织构型中的腔隙样结构是否存在及其大小有关。瘤内血管增生可能是等回声小肝癌的病理基础 Objective: To investigate the relationship between echogenicity and histopathological changes of small hepatocellular carcinoma (HCC). Methods: The echogenicity of 65 cases of small hepatocellular carcinoma (≤3.0cm) detected by ultrasound was compared with histopathological changes and histopathological types after operation. Results: Small hepatocellular carcinoma detected by ultrasound was most common in hypoechoic type and hypoechoic type. With the increase of cancerous nodules, hypoechoic type and hypoechoic type gradually increase. Steatosis or pseudosampus-like type has a higher ratio in hyperechoic type, but the same pathological changes can also occur in hypoechoic type . In the histological classification of small hepatocellular carcinoma, the tube shape and the gonadal shape containing the lacunar structure (sinusoids or duct-like dilatation) can be seen in echoes of different intensities and weaknesses, with and without sclerosis Type and compact, then focus on the low echo type. Intraepithelial neovascularization is the most common echo type. Conclusion: The echogenicity of small hepatocellular carcinoma is mainly related to the presence and size of the lacunar structures in the pathological changes of steatosis or pseudo-gland-like changes. Intratumor vascular hyperplasia may be the etiology of small hepatocellular carcinoma and other pathological basis