Abstract: Objective : To explore the clinical feasibility and value of CT perfusion imaging (CTPI) in the bone-musclesystem and to determine whether any of the CTPI parameters would be useful for differentiating between pri-mary benign and malignant bone tumors. Methods : Perfusion CT of primary bone tumor was performed with64-section multi-detector row CT in 33 patients and the time-density curve (TDC) and the perfusion parame-ters including blood flow (BF), blood volume (BV), time to peak (TTP) and permeability surface (PS) were ob-tained. Twenty-four cases were diagnosed as primary malignant bone tumor (the malignant group, n=24).Nine cases were diagnosed as primary benign bone tumor (the benign group, n=9). The adjacent normal mus-cle tissues from the 24 cases of primary malignant bone tumor were used as controls (the control group, n=24). Perfusion parameters of the three groups were compared. A statistical analysis was performed withKruskal-Wallis H test and Wilcoxon rank sum test. Results : The TDC was different between the malignantgroup and the benign group. The TDC of the benign group was smooth. However, the TDC of the malignantgroup appeared similar to a tachy-ascensus model. BF, BV and PS among the three groups were significantlydifferent (P<0.05). No significant difference was found in TTP between the malignant group and the benigngroup (P>0.05). Compared with the control group, the malignant group and the benign group showed higherBF, BV and PS (P<0.05), but TTP was not significantly different among the three groups (P>0.05). BF and BVwere higher in the malignant group than in the benign group (P<0.05). No significant difference was found in the value of PS and TTP between the malignant group and the benign group (P>0.05). Conclusion : CTPI canbe used in the bone-muscle system. TDC and the value of BF and BV are useful for differentiating primary be-nign bone tumors from malignant ones.