目的 旨在探讨256层极速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月至2018年3月收 治的肺癌患者52例，总结肺癌在256层极 速CT平扫及CT三期增强扫描中的图像表现 特征，以病理检查结果为对照，计算256 层极速CT平扫及CT三期增强对肺癌的检出 率及诊断正确率。结果 256层极速CT平扫 对肺癌的总检出率及总诊断正确率分别为 92.30%、88.46%，256层极速CT三期增强 对肺癌的总检出率及总诊断正确率分别为 100%、96.15%，256层极速CT三期增强对 肺癌的总检出率明显高于256层极速CT平 扫(100% vs 92.30%)(P<0.05)； 256层极 速CT三期增强与CT平扫对肺癌的总诊断正 确率比较无明显差异(P>0.05)；CT平扫图 像显示病灶部位：左肺23例，右肺29例， 256层极速CT平扫可见多数病灶呈密度均 匀的团块样软组织密度影，边界清晰，气 管支气管腔内病灶表现为宽基底与气管 相连且突入腔内，5例病灶与邻近纵隔大 血管结构分界模糊，4例纵隔内淋巴结肿 大。三期增强扫描中，多数患者动脉期病 灶明显强化，门脉期病灶区域持续强化， CT值最高，16例患者呈现不均匀强化，5 例患者出现“环形”强化，平衡期呈轻、 中度强化。结论 256层快速CT非增强扫描 和三期对比增强扫描均能有效诊断肺癌， 直接显示病变的图像变化特征，指导临床 制定相关治疗方案。

Objective To explore the value of the plain scan and triple-phase contrastenhanced scans in the diagnosis of lung cancer. Methods A total of 52 patients with lung cancer admitted to our hospital from September 2016 to March 2018 were selected. The imaging features of lung cancer in the 256-slice flat-scan and triple-phase contrastenhanced scans were summarized, and the detection rate and diagnostic accuracy of the 256-slice flat-scan and triple-phase contrast-enhanced scans were calculated based on the pathological examination results. Results The total detection rate and diagnostic accuracy of the 256-slice extreme CT non-enhanced scanning for lung cancer were 92.30% and 88.46% respectively, the total detection rate and diagnostic accuracy of the 256-slice extreme triple-phase contrast-enhanced scans for lung cancer were 100% and 96.15% respectively, and the total detection rate of the 256-slice extreme triple-phase contrastenhanced scans for lung cancer was significantly higher than that of the 256-slice extreme CT non-enhanced scanning (100% vs 92.30%) (P<0.05). There was no significant difference in the overall diagnostic accuracy between the triple-phase contrast-enhanced scans and the CT non-enhanced scanning (P>0.05). CT scan images showed lesions: 23 cases of left lung, right lung 29 cases, CT scan shows most of the lesions was soft tissue density, the boundary is clear, tracheal bronchus cavity lesions images show the wide base with the trachea and into cavity, 5 cases of mediastinal large blood vessels of the lesions and adjacent structures boundary fuzzy, 4 cases of mediastinal lymph node enlargement. In triple-phase contrast-enhanced scans, most of the patients had obvious enhancement in arterial phase, and continuous enhancement in portal phase with the highest CT value, 16 patients showed heterogeneous enhancement, 5 patients showed "circular" enhancement, and mild and moderate enhancement in the balanced phase. Conclusion Both the nonenhanced scan and the triple-phase contrast-enhanced scans of the 256-slice rapid CT can effectively diagnose lung cancer, and display the image change characteristics of the lesions directly, and guide the clinical formulation of relevant treatment plans.