肺孤立性结节一直是CT诊断中的难点，诊断主要依据结节大小、形态学改变及与周围支气管、血管、胸膜关系等，由于同病异影或异病同影征象的存在且常规CT诊断模式较单一，鉴别诊断较为困难。而能谱CT的出现是CT成像的重要变革，本文中作者根据能谱CT成像的特性综述了能谱CT在孤立性肺结节定性诊断方面的应用，包括肺结节的检出、能谱多工具分析平台在孤立性肺结节定性及鉴别诊断、肺癌分型、分期等方面的应用，指导孤立性肺结节的诊疗及预后预测，同时对能谱CT用于磨玻璃结节定量定性诊断进行了简单展望。

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