目的　探讨256层CT灌注成像和三维重建技术对乳腺疾病诊断和术前评估的意义。  方法　采用256层CT对50例经彩超或钼靶发现有乳腺肿物的患者进行灌注扫描，结合术后病理结果，分析不同性质乳腺肿瘤组织和正常乳腺组织的灌注成像指标，以及乳腺三维重建对临床手术的指导作用。  结果　256层CT灌注成像指标值对鉴别诊断乳腺良恶性肿瘤具有重要的参考价值；三维重建模型可以全方位地观察病灶情况，为术前评估提供了依据。   结论　256层CT灌注成像能从血流动力学方面鉴别诊断乳腺良恶性肿瘤；三维重建可为临床诊断、治疗提供更多的信息，有助于乳腺癌的术前评估。

Objective   To explore the significance of 256 slice CT perfusion imaging and three-dimensional reconstruction technology for diagnosis and preoperative evaluation of breast disease.   Methods  50 patients found breast tumors by color doppler ultrasound or mammography underwent 256 slice CT perfusion scan, combined with the postoperative pathological results, analyzed the perfusion imaging indexes of different nature of breast neoplasm tissue and normal breast tissue, and three-dimensional reconstruction of guidance for clinical surgery.   Results   The perfusion imaging indexes of 256 slice CT had important reference value in differential diagnosis of benign and malignant breast tumors, three-dimensional reconstruction model could observe lesions in all situations, and provided the basis for preoperative assessment.   Conclusion   256 slice CT perfusion imaging can be helpful to differentiate the breast cancer from benign breast tumor from the aspects of hemodynamics. three-dimensional reconstruction can provide more information for clinical diagnosis, treatment, and help to preoperative evaluation of breast cancer.