【摘要 】 目的 进一步评价结核结节和肺癌的CT 影像特点和鉴别诊断价值。方法 对比分析直径<2.0 cm 的结核结节30 例和肺癌40 例的CT 影像。结果 结核结节以边缘光滑或清楚、无分叶而有小空洞、钙化、胸膜增厚粘连、卫星病灶或病灶周围炎多见，并有短期内动态形态改变。肺癌以边缘毛糙、浅分叶、空泡征、空气支气管征、典型胸膜凹陷征多见，短期动态形态不变。结论 薄层CT 扫描可提供有价值的征象，短期内动态观察是二病重要鉴别手段。

Zhou Xinhua, Xie Ruming, ChenJi, et al. Beijing Tuberculosis ＆ ThoracicTumour Institute, Beijing 101149

【Abstract 】 Objective To find out the CT characteristics of tuberculous nodules and lungcancers with diameters less than 2 cm, and to evaluate their value in differentiating thetwo diseases. Method TheCT images in thirty patients with tuberculous nodules and fourty lung cancer patients withlesions less than 2 cm in diameter were compared. Result Smooth or clear edge, non-lobulation, small cavity,calcification, pleural thicking and adhesion, satellitic nidus and perifocal inflammationwere found predominant in tuberculous nodules with short-term dynamic changes in shapes,while shaggy border, shallow lobulation, vacuolus sign, air-bronchogram and typicalpleural indentation were predominant in lung cancers without dynamic changes in shapes. Conclusion Thin-slice CT scanning can provide useful images, which byshort-term observations are important for differentiating these diseases.

     【Key words 】 Tuberculosis, pulmonary Lung neoplasm Diagnosis,differential Tomography, x-ray computed

肺部孤立病灶的鉴别诊断一直是影像学的棘手问题^{[1 ～3 ]} ......