目的 探究能谱CT成像在孤立性 肺结节良性和恶性鉴别诊断中的应用价 值。方法 采用回顾性分析的方法对我院 2014年6月-2016年5月收治的51例患者进 行研究分析，51例患者入院后两周内都行 宝石能谱CT平扫加增强双期扫描，并经 手术、纤维支气管活检或者穿刺活检进 行确诊。结果 51例患者中良性结节组24 例和恶性结节组27例；良性肺结节组中的 两期标准化浓度(NIC)和标准化碘浓度差 都较恶性肺结节组要低，两组间的差别具 有统计学差别，P<0.05；双期扫描在动脉 期的标准化浓度确诊良性和恶性的结节中 准确率是最高的;静脉期标准化浓度临界 值选取0.412时特异度为100%，标准化碘 浓度临界值选取0.265时，特异度也同样 在100%；动脉标准化浓度中当临界值选取 0.161时确诊率最高达85.35%。结论 能谱 CT成像在孤立性肺结节良性和恶性鉴别诊 断中具有重要的应用价值。

Objective To investigate the application value of spectral CT imaging on differential diagnosis of benign and malignant of SPN. Methods 51 cases in our hospital from January 2013 to July 2016 were selected and retrospectively analyzed. Patients were all given precious stones energy spectrum CT scan and dual-phase enhanced scanning and then diagnose by surgery, fiber bronchial biopsy and aspiration biopsy. Results Of 51 cases, 24 cases in BSPN group and 27 cases in malignant SPNs group. NIC and standardized concentration difference of BSPN group were lower than malignant SPNs group, the difference was statistically significant (P<0.05). Dual scan in arterial phase had the highest accuracy rate on differential diagnosis of benign and malignant of SPN. In venous phase, specificity was 100% when standardized concentration threshold was 0.412 or 0.265. Specificity was 85.35% when standardized concentration threshold was 0.161. Conclusion Spectral CT imaging has important application value on differential diagnosis of benign and malignant of SPN.