目的 分析肺结核合并肺癌的CT 影像学表现，为其诊断提供参考依据。 方法 选取2013年4月至2014年9月我院收 治的肺结核合并肺癌患者40例为研究对 象，另选取合并肺内肿物的单纯肺结核患 者40例为对照组，观察两组临床表现，记 录CT检查时肺内肿物的形态、部位、肿物 边界征象，分析两组CT影像特征并进行 对比。结果 两组均以反复咳嗽、痰中带 血、胸闷、气短、胸痛、消瘦、低热等为 主要临床表现，观察组未出现明显特异性 表现；观察组CT影像以分叶征、毛刺征、 空泡征并发肺不张、棘状突起、空洞、血 管束聚集征、胸膜凹陷等为主要表现；影 像学特征对比发现，观察组CT影像中肿块 70.00％、分叶征60.00％、毛刺状结节 32.50％、胸膜凹陷75.00％比例明显高 于对照组27.50％、35.00％、10.00％、 32.50％，观察组空洞比例12.50％低于对 照组32.50％，差异均有统计学意义（P 均<0.05），两组条索影比例5.00％、 12.50％比较无显著差异（P>0.05）。结 论 肺结核合并肺癌的CT影像学主要表现 为分叶征、毛刺征、棘状突起、空泡征并 发肺不张、空洞、胸膜凹陷，临床应根据 该特点并结合临床表现与病史进行诊断。

Objective To analyze the CT imaging findings of pulmonary tuberculosis complicated with lung cancer, and provide reference for the diagnosis. Methods Forty patients with pulmonary tuberculosis complicated with lung cancer treated in our hospital between April 2013 and September 2014 were selected as the observation group. Another 40 cases with pulmonary tuberculosis complicated with neoplasms in lung were selected as control group. The clinical manifestations of both groups were observed. Shape, location and the boundary signs of neoplasms in lung were recorded during CT examination, and CT imaging findings of both groups were analyzed and compared. Results The main manifestations of both groups were recurrent cough, blood-stained sputum, chest tightness, shortness of breath, chest pain, emaciation and low-grade fever,etc..There were no specific manifestations in the observation group; The main CT imaging findings in the observation group were lobulation sign, spicule sign, vacuole sign complicated with pulmonary atelectasis, spiculate protuberance, cavity, vascular bundle aggregation sign and pleural indentation, etc. Imaging comparison showed that in CT findings of the observation group,neoplasms accounted for 70.00%, lobulation sign for 60.00%, spiculate nodules for 32.50% and pleural indentation for 75% which were significantly higher than those in the control group (27.50%, 35.00%, 10.00%, 32.50%). The proportion of cavity in the observation group(12.50%) was lower than that in the control group (32.50%) (P<0.05). There was no significant difference in the proportion of stripped shadow between the two groups (5.00%, 12.50%) (P>0.05). Conclusion The main CT imaging findings of pulmonary tuberculosis with lung cancer included lobulation sign, spicule sign, spinous protuberance, vacuole sign complicated with pulmonaryatelectasis, cavity and pleural indentation. Clinical diagnosis of the disease should be performed according to the characteristics and clinical manifestations.