探讨低剂量能谱CT在肺结节良性和恶性鉴别诊断中的应用价值。

回顾性分析江苏省苏北人民医院2015年6月至2016年12月期间行能谱CT检查共73个肺部肿块或结节，分析病变动脉期、静脉期的碘物质浓度、水物质浓度、标准化能谱曲线斜率。所有病例均经手术、纤维支气管活检或者穿刺活检确诊。

73个结节中，良性结节34个，恶性结节39个，动脉期恶性结节的碘物质浓度、水物质浓度、标准化能谱曲线斜率(10.93±5.12、1 033.96±9.74、0.998±0.66)均明显高于良性结节(5.29±0.96、1 028.85±9.31、0.620±0.16)，差异有统计学意义(P值分别为0.000、0.008、0.001)。静脉期恶性结节的碘物质浓度、水物质浓度、标准化能谱曲线斜率(9.18±4.17、1 018.43±8.13、0.89±0.27)均明显高于良性结节(4.77±0.81、1 015.61±6.71、0.46±0.14)，差异有统计学意义(P值分别为0.000、0.006、0.001)。

低剂量能谱CT成像在孤立性肺结节良性和恶性鉴别诊断中具有重要的应用价值。

To evaluate the application value of low-dose spectral CT imaging in differential diagnosis of benign and malignant of solitary pulmonary nodule(SPN).

The spectral CT imaging data of 73 pulmonary masses or nodules collected from June 2015 to December 2016 in Subei People′s Hospital of Jiangsu Province were retrospectively analyzed.The iodine concentration, water concentration and normalized spectral curve slope rate were measured on the lesions in arterial and venous phase images.All the pulmonary nodules or masses were confirmed by surgery, fiber bronchial biopsy and aspiration biopsy.

Among 73 pulmonary nodules or masses, 34 cases were benign, and 39 cases were malignant.In arterial phase, the iodine concentration, water concentration and normalized spectral curve slope rate of malignant nodules(10.93±5.12, 1 033.96±9.74, 0.998±0.66)were obviously higher than those of benign nodules(5.29±0.96, 1 028.85±9.31, 0.620±0.16), with significant differences(P=0.000; P=0.008; P=0.001). In venous phase, the iodine concentration, water concentration and normalized spectral curve slope rate of malignant nodules(9.18±4.17, 1 018.43±8.13, 0.89±0.27)were obviously higher than those of benign nodules(4.77±0.81, 1 015.61±6.71, 0.46±0.14), with significant differences(P=0.000, P=0.006, P=0.001).

Low-dose spectral CT imaging has important application value on differential diagnosis of benign and malignant of SPN.