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目的 分析肺癌及淋巴结转移灶在不同单能量下CT值、碘(水)密度变化,以探讨能谱CT在肺癌及淋巴结转移灶诊断中的临床价值.方法 回顾性分析经临床病理确诊的42例肺占位性病变患者能谱CT成像的临床资料.其中良性疾病19例(良性组),肺癌23例(肺癌组).结果 能谱CT成像诊断肺占位性病变及淋巴结转移灶的x2值分别为26.1和153.8,差异无统计学意义(P＞0.05).肺恶性占位性病变keV越低,CT值差异越大.良性组动脉期标准化碘密度(0.13±0.08) g/L显著低于肺癌组的(0.20±0.15) g/L,差异有统计学意义(P＜0.05);良性组动脉期标准化水密度(1.01±0.01) g/L与肺癌组(1.00±0.01)g/L比较差异无统计学意义(P＞0.05).淋巴结转移灶能谱曲线斜率(1.10±0.07)与原发肺癌灶(1.07±0.08)一致,差异无统计学意义(t=1.83,P＞0.05).鳞癌、腺癌、小细胞肺癌在不同单能量下成像,能谱曲线斜率比较差异无统计学意义(P＞0.05).结论 能谱CT在肺癌及淋巴结转移灶的检出上具有明显优势,其定量分析有助于肺部良恶性占位及淋巴结的诊断及鉴别诊断,在临床较难诊断病灶的鉴别诊断中有重要价值.“,”Objective To analyze the change of CT value,iodine (water) density in lung cancer and lymph node metastases under different single-energy,and investigate the clinical value of spectrum CT in the diagnosis of lung cancer and lymph node metastases.Methods The clinical and pathological diagnosis of 42 patients with lung lesions,the clinical data of spectrum CT imaging were retrospectively analyzed.Nineteen cases with benign diseases (benign group),23 cases with lung cancer(lung cancer group).Results Thex2 value of spectrum CT imaging in the diagnosis of lung lesions and lymph node metastases was 26.1 and 153.8,there was no significant difference(P ＞ 0.05).Malignant lung lesions lower keV,the greater difference in CT value.The arterial phase standard iodine density in benign group was lower than that in lung cancer group [(0.13 ± 0.08) g/L vs.(0.20 ± 0.15) g/L],there was significant difference (P ＜ 0.05).The arterial phase standard water density between benign group and lung cancer group had no significant difference [(1.01 ± 0.01) g/L vs.(1.00 ±0.01) g/L] (P＞ 0.05).Spectrum curve slope in lymph node metastases and lung cancer had no significant difference (1.10 ± 0.07 vs.1.07 ± 0.08)(t =1.83,P ＞ 0.05).The spectrum curve slope of squamous carcinoma,adenocarcinoma and small cell lung cancer under different energy imaging had no significant difference (P ＞ 0.05).Conclusion Spectrum CT has obvious advantages in detection of lung cancer and lymph node metastases,and its quantitative analysis is helpful in the diagnosis and differential diagnosis of benign and malignant lung tumor and lymph nodes,in the differential diagnosis of clinical difficult to diagnosis lesions has significant value.