目的研究比较64层CT灌注成像 对于孤立性肺结节(SPN)良恶性的诊断价 值及临床应用。方法 对于我院2011年 11月至2013年11月50例未经治疗的直径 ≤3cm的肺孤立结节根据病理结果分为 恶性结节组和良性结节组，分别进行64 层螺旋CT灌注成像，计算结节的血流量 (BF)、血容量(BV)、平均通过时间(MTT) 和通透性值(PS)。同时绘制同层面结节 的时间-密度曲线(TDC)，判断结节良恶 性，和手术病理结果进行对比分析， 计算各灌注参数对于孤立性肺结节良恶 性诊断的准确率、敏感性和特异性。结 果 经CT引导下肺穿刺活检或手术病理 证实，发现恶性结节34例，良性结节16 例。两组结节的各灌注参数差异显著， P<0.01；同层面结节的TDC曲线良恶性 差异显著，有助于提示结节性质，血容 量(BV)、平均通过时间(MTT)、血流量 (BF)和通透性值(PS)对于孤立性肺结节 良恶性诊断的准确率、敏感性和特异性 分别为88%，88.24%，87.50%；90%， 94.12%，81.25%；94.00%，91.12%， 100.00%；86.00%，94.12%，68.75%。结 论 64层CT灌注成像技术有助于早期诊断 孤立性肺结节性质，为进一步治疗方案 提供思路。

Objective Comparative study of 64 slice CT perfusion imaging in solitary pulmonary nodules (SPN) and clinical application value in diagnosis of benign andmalignant. Methods For November to 2013 November in our hospital in 2011 50 cases of untreated diameter ≤ 3cm in solitary pulmonary nodules based on the pathological findings were divided into malignant nodules group andbenign SPNs group, respectively with 64 slice spiral CT perfusion imaging, bloodflowcalculation nodules (BF), bloodvolume (BV), theaverage pass time (MTT) and permeability value (PS). At the same time,rendering the same level nodules of time density curve (TDC),differentiating the benign and malignant nodules, and operation and pathology results were compared and analyzed, calculated the perfusion parameters for accuracy, diagnosis of malignant solitary pulmonarynodules sensitivity and specificity. Results He CT guided lung biopsy or operation and confirmed by pathology,found 34 cases of malignant nodules, 16 cases with benign nodules. Theperfusion parameters between two groups nodule significantly, P<0.01;TDC curve level with the benign and malignant nodules differ significantly, helps to prompt nodules (BV), blood volume, mean transit time (MTT), blood flow (BF) and permeability values (PS) for benign and malignant solitary pulmonary nodules, accuracy diagnostic sensitivityandspecificitywere 88%, 88.24%, 87.50%; 90%, 94.12%, 81.25%; 94%,91.12%, 100%; 86%, 94.12%, 68.75%. Conclusion 64 slice CT perfusion imaging is helpful to early diagnosis of solitary pulmonary nodules, provide ideas for further treatment.