Objective To investigate the values of spectral CT imaging in differentiating primary lung cancer and lung metas -tasis.Methods Patients with nodules or masses on plain CT underwent CT dual-phase enhancement scans , including 32 patients with primary lung cancer and 23 ones with lung metastasis .At 40~70 keV, the mean CT values , energy spectrum curves , iodine concentrations and water concentrations were measured and compared between primary lung cancer and lung metastasis during ar -terial and venous phase .Results Between primary lung cancer and lung metastasis ,significant difference can be found in mean CT values, the slope rates of spectrum energy curves and the iodine concentrations in arterial phase ( P <0.05), while, water concentrations were found no significant difference between them ( P >0.05).The above-mentioned spectrum parameters were found no significant difference between primary lung cancer and lung metastasis in venous phase ( P >0.05).Monochromatic im-ages can well show the blood vessels in and surround the tumor .Additionally , central lung cancer may cause reduced blood perfu-sion of involved lung tissue .Conclusion Spectral CT plays an important role in differentiating primary lung cancer and lung me-tastasis.%目的：探讨CT能谱成像在原发性肺癌与肺转移瘤鉴别诊断中的价值。方法对平扫发现肺部肿块或结节的患者行GE能谱CT增强扫描，其中原发性肺癌32例，肺转移瘤23例。在动脉期和静脉期40～70 keV单能量条件下，分别测量并比较两组病灶的平均CT值、碘浓度、水浓度及能谱曲线差异。结果在动脉期，原发性肺癌组的平均CT值、能谱曲线斜率、碘浓度低于肺转移瘤组，差异有统计学意义（ P ＜0．05），两组间水浓度差异无统计学意义（ P ＞0．05）；在静脉期，原发性肺癌组与肺转移瘤组间各能谱参数差异无统计学意义（ P ＞0．05）。单能量图像可以更好的显示肿块内及其周围血管的情况。另中心型肺癌可以导致受累肺组织血流灌注减低。结论能谱CT在原发性肺癌和肺转移瘤的鉴别诊断中有一定的临床价值。
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