目的 探讨三期动态CT增强扫描 技术对诊断右肺上叶肺癌及纵膈淋巴结转 移的临床应用价值分析。方法 选取2015 年1月-2016年8月我院因肺癌进行CT平扫 与三期动态CT增强扫描检查的患者56例。 整理56例患者的临床及影像学资料，由 两名经验丰富的放射科诊断医师共同评估 观察CT平扫与增强扫描图像，对肺癌的影 像特征及转移情况进行分析。结果 病理 检查结果显示，56例患者的肺癌均以单发 为主，其中有38例患者伴有纵膈淋巴结转 移。CT增强扫描对56例患者的肺癌检出率 为94.64%，其中检出肺癌类型为鳞癌的有 13例，腺癌18例，小细胞癌13例，鳞腺混 合癌9例，其中检出32例患者伴有纵膈淋 巴结转移，其确诊率为84.21%。CT增强扫 描对右肺上叶肺癌的确诊率与病理检查结 果无明显差异(χ2 =22.267，P=0.079)。 患者右肺上叶病灶区在三期动态CT增强扫 描图像出现明显强化，且病变周围组织以 及纵膈淋巴转移情况显示清楚。结论 三 期动态CT增强扫描图像对患者右肺上叶结 构变化显示突出，能直观、全面的准确显 示病变区，能及时发现纵膈淋巴转移，有 利于影像医生对病变部位进行精确定位显 示，可为临床提供重要影像学资料，帮助 临床医生诊断，指导临床医生制定正确的 治疗方案，值得临床推广和应用。

Objective To investigate the clinical value of three-phase dynamic contrastenhanced scanning in the diagnosis of right upper lung cancer and mediastinal lymph node metastasis. Methods From January 2015 to August 2016, 56 cases of patients with lung cancer undergoing CT scan and three-phase dynamic contrast-enhanced scan in our hospital were studied. The clinical and imaging data of 56 patients were collected. Two experienced diagnostic radiologists evaluated CT scan and enhanced scan, and analyzed the imaging features and metastasis of lung cancer. Results The pathological examination showed that all 56 patients had single lung cancer, of which 38 patients had mediastinal lymph node metastasis. The detection rate of lung cancer in CT scan was 94.64% in 56 patients. Among them, 13 cases were diagnosed as squamous cell carcinoma, 18 cases were adenocarcinoma, 13 cases were small cell carcinoma and 9 cases were mixed adenocarcinoma. 32 patients with mediastinal lymph node metastasis, the diagnosis rate was 84.21%. There was no significant difference between the CT scan and the pathological findings of the right upper lung cancer (χ2 =22.267, P=0.079). In the right upper lobe of the lung, the lesion area in the third phase of dynamic contrast-enhanced enhanced imaging was significantly enhanced, and the surrounding tissue and mediastinal lymph node metastasis was clearly demonstrated. Conclusion Three-phase dynamic contrastenhanced computed tomography (CT) images of the upper right lobe of the lung showed more prominent changes in the structure of the right upper lobe, which can directly and completely display the lesion area and find the mediastinal lymphatic metastasis in time, which is beneficial for the imaging doctor to accurately locate the lesion site Display, can provide important clinical imaging information to help clinicians diagnose, guide clinicians to develop the correct treatment program, it is worth clinical promotion and application.