目的 探究640层螺旋CT采用容 积扫描模式在肺内结节诊断与鉴别诊断 中的应用。方法 选取经临床检查证实肺 内结节的患者共28例，其中肺癌8例，结 核球12例，炎性结节8例。采用东芝640 层螺旋CT扫描仪器对患者进行扫描，后 将结果上传至工作站进行处理，根据图 像结果进行诊断和鉴别诊断。结果 所有 结节注射对比剂之前平扫CT值结果不存 在显著差异，注射对比剂后三种结节最 大增强CT值随时间变化趋势存在差异， 且差异显著。三种结节增强类型也存在 显著性差异，肺癌结节大部分表现为均 匀强化，结核球表现为无明显强化，炎 性结节主要表现为边缘强化。结论 640 层螺旋CT容积扫描在肺内结节诊断与鉴 别中存在一定价值，对肺内孤立性小结 节的诊断具有一定的指导作用。

Objective To explore the application of 640-slice spiral CT with volume scan in the diagnosis and differential diagnosis of pulmonary nodules. Methods 28 cases of pulmonary nodules were confirmed by clinical examination, including 8 cases of lung cancer, 12 cases of tuberculoma and 8 cases of inflammatory nodules. The patient was scanned with a Toshiba 640-slice spiral CT scanner, and the results were uploaded to a workstation for processing and diagnosis and discrimination based on the image results. Results There was no significant difference in CT value between all the patients before injection of contrast agent, and there was a significant difference between the three groups after injection of contrast agent and the trend of time difference. Three types of patients with enhanced type there are significant differences in lung cancer patients are mainly enhanced, tuberculosis ball is not strong and inflammatory nodules to strengthen the main way around the strengthening. Conclusion There is a certain value in the diagnosis and differential diagnosis of pulmonary nodules by spiral CT volume scan. It has a certain guiding effect on the diagnosis of solitary pulmonary nodules.