目的 探讨能谱CT对肺内占位良 恶性的鉴别及诊断价值。方法 选择我院 2015年3月至2017年10月经影像学检查(X 线、CT)发现肺内占位的57例患者作为研 究对象，根据病理检查结果将其分为良性 占位组(n=21)和恶性占位组(n=36)。两组 患者均实施能谱CT成像技术，并对图像 进行分析处理，对比两组动、静脉期40- 80keV隔间单能量CT值，动脉期40-70keV 期间能谱斜率，动、静脉期碘和水基值及 差值。结果 动、静脉期40-80keV隔间单 能量CT值及动脉期40-70keV期间能谱斜 率，良性占位组均低于恶性占位组，差异 有统计学意义(P＜0.05)。动、静脉期碘 基值及差值，良性占位均低于恶性占位， 差异有统计学意义(P＜0.05)；动、静脉 期水基值及差值，良性占位均高于恶性占 位，差异有统计学意义(P＜0.05)。结论 肺内占位良恶性在能谱CT表现上存在一定 差异，其诊断结果对临床诊断具有一定参 考价值。

Objective To explore the identification and diagnostic value of energy spectrum CT for benign and malignant lung lesions. Methods A total of 57 patients with pulmonary lesion examined by X-ray and chest CT from March 2015 to October 2017 were selected for the study. According to the pathological examination results, the patients were divided into benign lesion group (n=21) and malignant lesion group (n=36). The two groups were given energy spectrum CT imaging technique, and the images were analyzed and processed. The single-energy CT values of 40-80 keV compartments in arterial and venous phases, and the energy spectrum slope of 40-70 keV compartments in arterial phase, iodine base value and water base value and difference in arterial and venous phases were compared between the two groups. Results The single-energy CT values of 40-80 keV compartments in arterial and venous phases were lower in benign lesion group than those in malignant lesion group (P<0.05). There was a statistically significant difference in the energy spectrum slope of 40-70 keV compartments in arterial phase (P<0.05). The iodine base value and difference in arterial and venous phases were lower in benign lesion group than those in malignant lesion group (P<0.05). The water base value and difference in arterial and venous phases were higher in benign lesion group than those in malignant lesion group (P<0.05). Conclusion There are some differences in the energy spectrum CT findings of benign and malignant lung lesions. CT diagnostic results have certain reference value for clinical diagnosis.