To investigate the clinical value of 320-slice spiral CT in diagnosis of metastatic liver cancer with atypical CT manifestations.

Clinical data of 62 patients with metastatic liver cancer with atypical CT manifestations who were confirmed by the pathological examination and underwent 320-slice CT plain scan and enhanced scan in the First People's Hospital of Guangzhou from August 2010 to August 2014 were studied retrospectively. Of the 62 patients, 45 were males and 17 were females with the age ranging from 37 to 83 years old and the median of 63 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The imaging characteristics of the lesions by spiral CT plain scan and enhanced scan were observed, including density, number, boundary and enhancement pattern of the lesions.

On CT plain scan of the 62 cases, 94% (58/62) displayed low or slightly low density and 6% (4/62) displayed mixed high and low density, 77% (48/62) were with multiple lesions and 23% (14/62) were with single lesion; 79% (49/62) were with obscure boundary and 21%(13/62)were with well-defined boundary. On CT enhanced scan, 50% (31/62) were with progressive enhancement, 21% (13/62) were without obvious enhancement, 11% (7/62) were with wreath-like edge enhancement, 5% (3/62) were with fast in fast out enhancement and 13% (8/62) were with multiple patterns enhancement.

320-slice dynamic contrast enhanced spiral CT may better reflect the histological and blood supply characteristics of metastatic liver cancer with atypical imaging manifestations and provide more accurate imaging evidences for the formulation of clinical therapeutic regimen.