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１小肝癌（ＳＨＣＣ）的定义和病理ＳＨＣＣ多在慢性肝疾患基础上发生。对于ＳＨＣＣ的定义，目前大多数学者以直径≤３ｃｍ为标准［１］。本文亦以该大小标准定义ＳＨＣＣ，本文所有统计学数据均为在该标准基础上获得。对其病理演变过程，目前尚有２种观点：①肝硬化再生结节（ＲＮ）→腺瘤样增生（ＡＨ）→不典型腺瘤样增生（ＡＡＨ）→早期肝癌（ＥＨＣＣ）→ＳＨＣＣ；②ＲＮ→发育不良结节（ＤＮ）→含局灶肝癌的发育不良结节→ＳＨＣＣ［２］。ＳＨＣＣ在病理学上为单或多中心发生，多数呈膨胀性生长，组织学表现为特征性的嵌合体类型，６０％～８２％的肿瘤边缘有包膜，边界常清楚，内部常见脂肪变性，可伴有血管侵犯或肝内转移［１］。９０％～９５％的肿瘤血供丰富，表现为从ＲＮ发展至ＨＣＣ的血供以门静脉为主向以肝动脉为主演化的趋势，主要为肝动脉供血，亦常伴门静脉血供（尤于瘤灶周缘）［３］。早期ＳＨＣＣ细胞分化程度较高［１］。２检测小肝癌的各种影像学新技术ＳＨＣＣ多在慢性肝疾患基础上发生，临床多无症状，或仅表现为相应的肝功能损害，早期监测主要依靠ＡＦＰ及ＵＳ对ＨＣＣ高危人群的普查与随访。影像学研究的重点在于发现瘤灶与定位及明确侵犯范围，其次才是定性诊断。随?
1 The definition and pathology of small hepatocellular carcinoma (SHCC) SHCC often occurs on the basis of chronic liver disease. For the definition of SHCC, most scholars currently use the diameter ≤ 3cm as the standard [1]. This article also defines SHCC with this size standard. All statistical data in this article is based on this standard. There are two viewpoints about its pathological evolution: 1) Liver cirrhosis (RN) → Adenomatous hyperplasia (AH) → Atypical adenomatous hyperplasia (AAH) → Early liver cancer (EHCC) → SHCC; 2RN → Dysplastic nodules (DN) → dysplastic nodules containing focal liver cancer → SHCC [2]. The pathological changes of SHCC were single or multicentric. Most of them showed expansive growth. The histological features were characteristic chimera types. 60% to 82% of the tumors were covered with margins, the borders were often clear, and internal steatosis was common. Can be associated with vascular invasion or intrahepatic metastasis [1]. 90% to 95% of tumors are rich in blood supply, which shows that the blood supply from RN to HCC mainly evolves from the portal vein to the hepatic artery. It is mainly the hepatic artery supply, and is often accompanied by portal venous blood supply. Focal periphery) [3]. Early SHCC cells have a high degree of differentiation [1]. 2 Detection of various imaging techniques for small hepatocellular carcinoma SHCC occurs mostly on the basis of chronic liver disease, clinically asymptomatic, or only as a corresponding impairment of liver function, early monitoring relied on AFP and US screening for high-risk HCC populations. Follow-up. The focus of imaging studies is to find the location and definition of tumor foci and the extent of violations, followed by qualitative diagnosis. With the