目的 探讨不同病理类型肺癌 的双源CT双能量参数特征及诊断鉴别价 值。方法 以我院86例初诊肺癌患者均 接受双源CT双能量成像系统检测，其中 腺癌52例，鳞癌34例，扫描后分析鳞 癌、腺癌患者各期CT净增值和时间-密 度曲线，比较两组差异。结果 肺腺癌 主动脉达峰时间(21.04±0.23)s，肺 鳞癌(23.12±0.3)s，差异具有统计学 意义(P<0.05)；增强扫描各期CT净增 值比较，腺癌组在达峰时、达峰后第 60s、第100s显著高于鳞癌组，差异具 有统计学意义(P<0.05)；两组达峰后第 40s差异不具有统计学意义(P>0.05)； 肺腺癌增强扫描CT净增值在主动脉达 峰时最低(P<0.05)，在第40s显著上升 (P<0.05)，后随着时间推移呈逐渐上升 趋势；鳞癌CT净增值在主动脉达峰时最 低(P<0.05），在第40s达到最高点，在 第40-60s略有降低，第60-100s呈平台 期。结论 腺癌CT净增值时间-密度曲线 具有逐渐上升趋势特点，而鳞癌时间— 密度曲线具有先上升，后降低，再平缓 趋势，双源CT双能量成像可为腺癌、鳞 癌病理学诊断提供一定参考依据。

Objective To explore the dual-source CT dual-energy parameters and their value in differential diagnosis value of different pathological types of lung cancer. Methods A total of 86 cases of newly diagnosed lung cancer patients admitted to our hospital during November 2014-November 2016 were examined with dual-source CT dual -energy imaging, including 52 cases of adenocarcinomas and 34 cases of squamous cell carcinomas. After scanning, the CT net added values and time-density curve of patients with squamous cell carcinoma and adenocarcinoma in different phases were analyzed and compared. Results The time to peak of lung adenocarcinoma was (21.04±0.23)s, while of lung squamous cell carcinoma was (23.12±0.3)s (P<0.05). The CT net added values of enhanced scan in different phases in adenocarcinoma group to peak, 60s and 100s after reaching the peak were significantly higher than those of the squamous cell carcinoma group (P<0.05). There was no significant difference between the two groups at 40s after reaching the peak (P>0.05). The CT net added value of enhanced scan for lung adenocarcinoma was the lowest in aortic peak, it increased significantlyat the 40thsecond (P<0.05) and increased gradually over time. The CT net added value of squamous cell carcinoma was the lowest in aortic peak(P<0.05), it was the highest at the 40thsecond, slightly decreased at the 40th-60thsecond, and it was in platform stage in 60th100thsecond. Conclusion The time-density curve of adenocarcinoma CT net added value shows a gradually increasing trend while that of squamous cell carcinoma shows an firstly increasing, then decreasing and finally flat trend. Dual-source CT dual energy imaging can provide certain references for pathological diagnosis of adenocarcinoma and squamous cell carcinoma.