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目的 探讨能谱CT在卵巢良恶性肿瘤诊断中的价值.方法 回顾性分析行盆腔能谱CT增强扫描且经手术病理确诊患者58例,按照病理结果分为良性组(n=30)和恶性组(n=28),测量两组动脉期和静脉期碘含量、水含量、40～140 keV单能量下(间隔10 keV)平均CT值、40～100 keV间能谱曲线斜率及能谱曲线形态.对比分析病理及影像结果.结果 两组病变在动脉期和静脉期随着单能量增大能谱曲线形态呈弧形下降型,能量越低CT值差异越大;动脉期单能量40～100 keV间良性组CT值、能谱曲线斜率均小于恶性组,差异有统计学意义(P<0.05);静脉期60～140 keV间良性组CT值均大于恶性组,差异有统计学意义(P<0.05);动脉期良性组碘含量小于恶性组,差异有统计学意义(P<0.05);能谱CT对良性和恶性肿瘤的检出率分别为86.67％和85.71％,灵敏度分别为86.67％和80.00％,特异度分别为80.00％和86.67％,能谱CT与病理结果差异无统计学意义(Kappa值为0.72),一致性较高.结论 能谱CT多参数分析对卵巢原发良恶性肿瘤的诊断具有一定参考价值.“,”Objective To evaluate the effectiveness of spectral CT in the differential diagnosis of gynecologic ovarian tumors. Methods The clinical data of 58 patients with ovarian tumors undergoing spectral enhanced scan were retro-spectively analyzed. The results were confirmed by surgery and pathology. The patients were divided into two groups:benign group ( n=30) and malignant group ( n=28) . The following parameters were measured in the arterial phase and venous phase, including the iodine content (IC), water content (WC), average CT value of 40-140 keV (interval 10 keV) , slope of the energy spectrum curve between 40 and 100 keV, and shape of 40-140 keV energy spectrum curve. The pathological results were compared with spectral parameters, and the differential diagnostic value of spectral CT in gynecologic pelvic diseases was evaluated. Results The energy spectrum curve in the two groups both showed a decreased arc shape as single energy increased in the arterial phase and venous phase. The lower the energy, the greater the CT value difference. The CT values of 40-100 keV and slope of the energy spectrum curve in the arterial phase in thebenign group were significantly less than those in the malignant group ( P<0.05) . The CT values of 60-140 keV in the venous phase in the benign group were greater than those in the malignant group ( P<0.05) , while the iodine content in arterial phase was less (P<0.05). The detection rates of spectral CT in the diagnosis of benign and malignant tumors were 86.67％ and 85.71％, respectively. The sensitivity was 86.67％ and 80.00％, respectively, and the specificity was 80.00％ and 86. 67％. There was no statistically significant difference between the CT results and pathological results (κ=0.72) , and the consistency was high. Conclusion Multi-parameter analysis with spectral CT allows preliminary differential diagnosis of primary ovarian tumors.