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目的:探讨CT影像特点在偏执型首发精神分裂症诊断中的意义。方法:选取绍兴市第七人民医院2018年1月至2019年1月收治的偏执型首发精神分裂症患者45例为研究组，选取同期健康体检者40例为对照组，均行头部CT扫描，测量脑叶CT值，分析偏执型首发精神分裂症患者CT影像学特征，随访1年统计其复发率，评估CT的诊断效果。结果:研究组额叶CT值为（33.1±1.4）HU，低于对照组的（36.9±2.1）HU，差异有统计学意义（n t=9.914，n P<0.001）；研究组脑室扩大、脑沟增宽、蛛网膜囊肿及大枕大池患者占比分别为51.1%、24.4%、31.1%、20.0%，均高于对照组的5.5%、2.5%、2.5%、2.5%，差异均有统计学意义（χn 2=21.688、8.411、11.928、4.675，均n P<0.05）；研究组复发率为22.2% （10/45），复发者左侧额叶、右侧额叶CT值分别为（32.1±1.7）HU、（32.5±1.6）HU，明显低于未复发者的（35.0±1.9）HU、（34.9±1.7）HU，差异均有统计学意义（n t=4.348、3.985，均n P<0.001）。n 结论:偏执型首发精神分裂症患者的脑结构异常，表现为脑室扩大、脑沟增宽、蛛网膜囊肿及大枕大池；CT影像特点在偏执型首发精神分裂症患者中的诊断价值显著，有一定的推广价值和创新性。“,”Objective:To investigate the significance of CT imaging features in the diagnosis of first-episode paranoid schizophrenia.Methods:Forty-five patients with first-episode paranoid schizophrenia admitted to Shaoxing 7n th People's Hospital from January 2018 to January 2019 were included in the study group. An additional 40 healthy controls who received health examination were included in the control group. All participants underwent head CT scans and CT values of cerebral lobes were measured. CT imaging features of first-episode paranoid schizophrenia were analyzed. The recurrence rate of paranoid schizophrenia was calculated. The diagnostic effect of CT imaging on paranoid schizophrenia was evaluated.n Results:The CT value of the frontal lobe in the study group was significantly lower than that in the control group [(33.1 ± 1.4) HU n vs. (36.9 ± 2.1) HU, n t = 9.914, n P < 0.001]. The proportions of patients having ventricular enlargement, sulcus widening, arachnoid cyst and cisterna magna in the study group were 51.1%, 24.4%, 31.1% and 20.0% respectively, which were significantly higher than 5.5%, 2.5%, 2.5% and 2.5% respectively in the control group ( n χ2 = 21.688, 8.411, 11.928, 4.675, all n P < 0.05). The recurrence rate of paranoid schizophrenia in the study group was 22.2% (10/45). The CT value of the left and right frontal lobe in patients with recurrent paranoid schizophrenia was (32.1 ± 1.7) HU and (32.5 ± 1.6) HU respectively, which was significantly lower than (35.0 ± 1.9) HU and (34.9 ± 1.7) HU in patients without recurrent paranoid schizophrenia ( n t = 4.348 and 3.985, both n P < 0.001).n Conclusion:Patients with first-episode paranoid schizophrenia have brain structural abnormalities, as manifested by ventricular enlargement, sulcus widening, arachnoid cyst, and cisterna magna. CT imaging features are of great value in the diagnosis of first-episode paranoid schizophrenia. It deserves wide popularization and has a great innovation value.