近年来，随着影像学技术的逐渐发展，以及疫情和后疫情时代的胸部CT的广泛应用，肝脏囊性病变的检出率逐渐提高。肝脏囊性病变可分为良性和恶性两大类。良性病变主要包括单纯性肝囊肿、多囊性肝病、肝棘球蚴病、Caroli病、胆管错构瘤、肝内胆管囊腺瘤等。恶性病变包括肝内胆管囊腺癌。出血和感染是肝囊肿的常见并发症。虽然良性病变占据了绝大多数的比例，但仍应在临床实践中警惕恶性病变的发生。临床实践中需要综合考虑患者的囊肿数量、部位、大小、性质以及身体状况等情况，选择不同的治疗方法进行治疗。外科手术是肝棘球蚴病患者的主要治疗手段，在临床诊断为囊腺瘤时，应当及时考虑手术切除治疗，重视对Caroli病和胆管错构瘤患者进行随访检查，警惕胆管癌的发生。本文旨在结合笔者经验，阐述肝脏囊性病变的疾病类型、鉴别诊断和治疗选择。

In recent years， with gradual development of imaging technology and widespread application of chest CT during pandemic and post-pandemic era， the diagnostic rate of hepatic cystic lesions has been gradually elevated. Hepatic cystic lesions can be divided into benign and malignant types. Benign hepatic cystic lesions mainly include simple hepatic cyst， polycystic liver disease， hepatic echinococcosis，Caroli disease， bile duct hamartoma and intrahepatic biliary cystadenoma， etc. Malignant hepatic cystic lesions comprise intrahepatic biliary cystadenocarcinoma. Hemorrhage and infection are common complications of hepatic cysts. Although benign hepatic cystic lesions are dominant， the occurrence of malignant hepatic cystic lesions should be monitored in clinical settings. It is necessary to comprehensively consider the number，location， size and nature of the cystic lesions and physical condition of the patients and choose different treatment methods in clinical practice. Surgery is the main treatment for patients with hepatic echinococcosis.When patients are clinically diagnosed with cystadenoma， surgical resection should be considered in a timely manner. Extensive attention should be diverted to follow-up and examination for patients with Caroli disease and bile duct hamartoma in case of the incidence of cholangiocarcinoma. In this article， the types， differential diagnosis and treatment options of hepatic cystic lesions were reviewed based on clinical experience.