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[目的]探讨能量CT与PET/CT成像在胃癌淋巴结评估中的应用价值.[方法]收集在我科行双源CT双能量扫描及18F-FDG PET/CT显像并经手术病理证实的进展期胃癌患者56例的影像资料,根据病理结果将淋巴结分为转移性淋巴结与非转移性淋巴结,分别测量比较二者标准化碘浓度(normalized iodine concentration, NIC)及能谱曲线,并计算能量CT与PET/CT成像对胃癌淋巴结诊断效能.[结果]转移性淋巴结、非转移性淋巴结动脉期的NIC值分别为0.546±0.067、0.153±0.068,二者比较差异有统计学意义(P＜0.05);转移性淋巴结、非转移性淋巴结静脉期的NIC值分别为0.478±0.013、0.303±0.073,2组比较差异有统计学意义(P＜0.05).动脉期NIC诊断的效能:灵敏度69.8％、特异度91.2％.静脉期NIC诊断的效能:灵敏度78.3％、特异度85.6％.转移性淋巴结、非转移性淋巴结双期能谱曲线均为下降型,动脉期曲线斜率k为6.85时,诊断胃癌转移淋巴结的灵敏度为83.5％、特异度为85.7％,静脉期斜率k为6.56时,灵敏度为65.6％、特异度为96.7％.18F-FDG PET/CT对胃癌区域淋巴结转移诊断的灵敏度、特异性分别为64.5％、96.3％.[结论]能量CT与PET/CT在胃癌转移淋巴结的评估中,能量CT具有一定的优势.“,”[Objective] To explore the value of energy CT and PET/CT imaging in the evaluation of lymph node in gastric cancer. [Methods]Data of 56 patients with advanced gastric cancer in our hospital radiology department and underwent dual source CT dual energy scanning and 18F-FDG PET/CT imaging were collected from May 2016 to August 2017. The gastric cancer was confirmed by pathological examination. The patients were divided into normal group(no lymph node transfer)and transfer group according to the pathological examination. The normal lymph node standardization iodine concentration(normalized iodine concentration, NIC) and energy spectrum curve were calculated, then the gastric cancer lymph node metastasis in the two groups were compared to determine the efficacy of energy CT and PET/CT imaging on the diagnosis of lymph nodes metastasis in gastric cancer. [Results] The NIC value of metastatic lymph node arterial period was 0.546±0.067, and the non-metastatic lymph node was 0.153±0.068, and the difference was statistically significant(P＜0.05). The NIC value of metastatic lymph nodes in venous stage was 0.478 ±0.013, and the non-metastatic lymph node was 0.303 ±0.073, and the difference was statistically significant(P＜0.05). Efficacy of the diagnosis of arterial stage NIC: sensitivity 69.8％, specificity 91.2％. Efficacy of NIC diagnosis in venous stage:sensitivity 78.3％, specificity 85.6％. Gastric cancer metastasis lymph node and the lymph node type dual phase spectrum curves were decreased, arterial curve slope was 6.85 k, the sensitivity of diagnosis of gastric carcinoma metastasis lymph node was 83.5 ％, specific degrees was 85.7％; When the slope k was 6.56, the sensitivity was 65.6％, and the specificity was 96.7％. The sensitivity and specificity of 18F-FDG PET/CT for lymph node metastasis in gastric cancer were 64.5％ and 96.3％. [Conclusion]Energy CT has have a certain advantage compored with PET/CT in the assessment of lymph node metastasis in gastric cancer.