目的 分析螺旋CT三维重建在孤 立性肺结节良恶性的诊断中的价值。方 法 纳入2016年6月至2017年12月在我院就 诊的孤立性肺结节患者共66例作为研究对 象，所有患者均已确诊，记录患者的螺旋 CT三维重建以及CT平扫结果，与病理结果 相比较，观察螺旋CT三维重建以及CT平扫 结果的准确率。结果 三维重建成像在与 CT平扫血管集束征、胸膜凹陷征、短毛刺 征、空泡征以及分叶征等恶性征象的检出 中，三维重建在血管集束征、胸膜凹陷征 以及分叶征的检出率高于CT平扫，差异具 有统计学意义(P<0.05)；在空泡征的检出 情况比较，平扫检出阳性率高于三维重 建，差异具有统计学意义(P<0.05)；三维 重建的短毛刺征检出率稍高于CT平扫，但 二者差异并无统计学意义(P>0.05)。三维 重建成像对SPN良恶性的确诊准确率可高 达80.30%，明显高于CT平扫的60.61%。结 论 螺旋CT三维重建在孤立性肺结节良恶 性的诊断中具有一定的价值，在分辨孤立 性肺结节的良恶性中准确率较高，但仍有 部分病变不能完全分辨，甚至可能出现误 诊，要提高诊断率，需要应用增强、灌注 等多种方法有机的结合，综合应用，提高 准确率，取长补短，提高准确率。

Objective To analyze the value of spiral CT three-dimensional reconstruction in the diagnosis of benign and malignant solitary pulmonary nodules. Methods A total of 66 patients with solitary pulmonary nodules who were admitted to our hospital from June 2016 to December 2017 were included as the study subjects. All patients were diagnosed. The results of spiral CT three-dimensional reconstruction and CT plain scan were recorded. The accuracy of spiral CT three-dimensional reconstruction and CT plain scan was observed compared with pathological results. Results In the detection of malignant signs such as vascular cluster sign, pleural indentation sign, short burr sign, vacuole sign and lobulation sign, the detection rate of three-dimensional reconstruction was higher than that on CT plain scan(P<0.05), in the detection of vacuole sign, the positive rate of plain scan was higher than that of three-dimensional scan (P<0.05). The detection rate of short burr sign in three-dimensional reconstruction was slightly higher than that in CT plain scan, but there was no significant difference between them (P>0.05). The diagnostic accuracy of three-dimensional reconstruction imaging for benign and malignant SPN can be as high as 80.30%, which is significantly higher than that of CT scan(60.61%,P<0.05). Conclusion Spiral CT three-dimensional reconstruction has certain value in the diagnosis of solitary pulmonary nodules. It has high accuracy in distinguishing the benign and malignant of solitary pulmonary nodules. However, some lesions can not be completely distinguished or even misdiagnosed. To improve the diagnostic rate, it is necessary to combine various methods such as enhancement and perfusion to improve the accuracy and complement each other, improve accuracy.