Objective To analyze the differential diagnostic value of Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with low-dose computed tomography (CT) scanning for benign and malignant solitary pulmonary nodules. Methods A total of 105 patients with solitary pulmonary nodules admitted to our hospital from June 2022 to March 2024 were selected as the research subjects, and divided into negative (n=67) and positive (n=38) groups based on pathological diagnosis results. The diagnostic results and value of different examination methods were compared. Results The pathological diagnosis results showed that among the 105 patients with solitary pulmonary nodules, 38 cases were positive and 67 cases were negative. Thirty-seven cases were diagnosed as positive and 68 cases as negative by low-dose spiral CT. Among them, only 28 patients with true solitary pulmonary nodules were identified, the diagnostic sensitivity was 73.68% (28/38), the specificity was 86.57% (58/67), and the accuracy rate was 81.90% (86/105). DCE-MRI examination diagnosed 39 positive cases and 66 negative cases, of which only 29 cases were true positive solitary pulmonary nodules patients, the diagnostic sensitivity was 76.32% (29/38), the specificity was 85.07% (57/67), and the accuracy rate was 81.90% (86/105). Thirty-nine cases were diagnosed as positive and 66 cases negative by low dose spiral CT combined with DCE-MRI. Among them, only 36 patients had true positive solitary pulmonary nodules, with a diagnostic sensitivity of 94.74% (36/38), specificity of 95.52% (64/67) and accuracy of 95.24% (100/105). The sensitivity and accuracy of combined diagnosis using low-dose spiral CT and DCE-MRI were 94.74% and 95.24%, respectively, which was higher than that of single diagnosis, with a missed diagnosis rate of 5.26%, which was lower than that of single diagnosis (P<0.05). Conclusion The use of low-dose spiral CT combined with DCE-MRI for the diagnosis of benign and malignant solitary pulmonary nodules can improve the diagnostic efficiency in distinguishing between benign and malignant solitary pulmonary nodules, and provide guidance information for clinical diagnosis and treatment.