目的 旨在探讨螺旋CT平扫及三 期增强扫描在诊断肺癌中的价值。方法 选取我院2016年9月-2018年1月收治的肺 癌患者79例，收集患者的临床资料、影像 学资料等，分析、总结79例肺癌患者螺旋 CT平扫及三期增强扫描的影像表现。以手 术或病理活检结果为对照，比较螺旋CT平 扫与三期增强扫描诊断肺癌的敏感度、特 异度及准确率。结果 34例腺癌者CT净增 强值为(27.12±5.13)HU，21例鳞癌者CT 净增强值为(33.15±8.22)HU，24例小细 胞癌者CT净增强值为(22.00±7.96)HU， 不同病理类型的肺癌患者CT净增强值存在 明显差异性(F=14.39，P<0.001)；三期增 强扫描诊断肺癌的敏感度、特异度及准确 率分别为91.13%、89.87%、93.67%，明显 高于CT平扫68.35%、63.29%、69.62%，差 异具有统计学意义(P<0.001)；79例肺癌 患者CT平扫病灶直径1.02-5.62cm，41例 患者可见病灶呈现不规则形，病灶周围可 见“毛刺征”；12例患者病灶周围呈现 “分叶征”，纵隔淋巴结出现肿大，少数 患者伴肺不张、阻塞性肺炎。三期增强扫 描中，42例患者呈现中度强化，24例患者 呈现稍强化，13例患者呈现显著强化；仅 9例患者出现胸膜凹陷征。结论 螺旋CT三 期增强扫描诊断肺癌的敏感度、特异度及 准确率高，可为临床制定手术方案提供可 靠影像学资料。

Objective To explore the value of spiral CT non-enhanced scan and tri-phase enhancement scanning in the diagnosis of lung cancer. Methods A total of 79 patients with lung cancer admitted to our hospital from September 2016 to January 2018 were selected, and 79 patients' clinical data and imaging data were collected to analyze and summarize the image manifestations of spiral CT non-enhanced scan and tri-phase enhancement scanning in 79 patients with lung cancer. The diagnostic sensitivity, specificity and accuracy of non-enhanced scan and tri-phase enhancement scan of lung cancer were compared. Results The net CT enhancement value of 34 patients with adenocarcinoma was (27.12? 5.13) HU, the net CT enhancement value of 21 patients with squamous cell carcinoma was (33.15±8.22) HU, and the net CT enhancement value of 24 patients with small cell carcinoma was (22.00±7.96) HU; the net CT enhancement values of lung cancer patients with different pathological types were significantly different (F=14.39, P<0.001). The sensitivity, specificity and accuracy of tri-phase enhancement scanning in the diagnosis of lung cancer were 91.13%, 89.87% and 93.67%, respectively, significantly higher than those of CT non-enhanced scan (68.35%, 63.29% and 69.62%), and the difference had statistical significance (P<0.001). The diameter of CT non-enhanced scan lesions in 79 patients with lung cancer was 1.02~5.62cm. In 41 patients, the lesions showed irregular shape and "burrs" around the lesions. In 12 patients, there were "lobulation signs" around the lesion, swelling of mediastinal lymph nodes, and a few patients with atelectasis and obstructive pneumonia. In phase iii enhanced scanning, 42 patients showed moderate enhancement, 24 patients showed slight enhancement, and 13 patients showed significant enhancement. Only 9 patients showed pleural depression. Conclusion The sensitivity, specificity and accuracy of spiral CT tri-phase enhancement scanning in the diagnosis of lung cancer are high, which can provide reliable imaging data for the clinical development of surgery programs.