目的 分析以双肺多发空洞为主 要表现的曲菌病及肺结核的CT特点，以提 高其诊断和鉴别诊断水平。方法 收集确 诊的肺部多发空洞病例57例，其中肺结核 36例，肺曲菌病21例，分析其肺部多发空 洞的ＣＴ征象，比较两组空洞的分布、晕 征、空气新月征、空洞内菌丝、偏心空 洞、虫蚀样空洞、引流支气管、卫星灶等 出现率的差异，进行统计学分析，并分析 比较两者肺内伴随影像学表现及病灶动态 变化。结果 两组病例肺部多发空洞在分 布、形态、肺内伴随影像学表现及病灶动 态变化均有差异，对空洞形态相关征象出 现率行χ2 检验，有显著差异(P＜0.05)； 肺曲菌病空洞的特点主要是晕征、空气半 月征、空洞内菌丝，肺内伴随曲菌感染表 现，病灶变化快；肺结核空洞的特点主要 是多分布于两肺上叶尖后段和下叶背段、 偏心空洞、虫蚀样空洞、引流支气管、卫 星灶，肺内伴有结核感染表现，病灶变化 较慢。结论　CT检查有助于鉴别以双肺多 发空洞为主要表现的肺曲菌病和肺结核， 有重要的临床应用价值。

Objective To improve diagnosis and differential diagnosis through analyzing the CT characteristics of aspergillosis and pulmonary tuberculosis presenting with bilateral pulmonary multiple cavity. Methods 557 cases of patients with bilateral pulmonary multiple cavities were selected, in which 36 cases were pulmonary tuberculosis and 21 cases were pulmonary aspergillosis. Analyze the CT signs by comparing the distribution of cavities as well as occurrence difference of halo sign, air crescent sign, mycelia in cavities, eccentric cavity, worm-eaten cavity, drainage bronchus and satellite lesions in two groups to carry out statistic analysis, furthermore, compare and analyze pulmonary accompanying radiological performances and lesion dynamic changes between two groups. Results there were differences in distribution, shape, accompanying radiological performances and lesion dynamic changes of pulmonary multiple cavities between two groups. χ2 test was carried out in analyzing occurrence rate of signs relevant to cavity shape, the result had significant difference (P<0.05), main characteristics of pulmonary aspergillosis cavity were halo sign, air crescent sign, mycelia in cavities, with pulmonary aspergillums infection and rapid lesion changes; main characteristics of pulmonary tuberculosis cavity were main locating in superior lobe apicoposterior segment and lower lobe dorsal segment of bilateral lungs, eccentric cavity, worm-eaten cavity, drainage bronchus and satellite lesions, with pulmonary tuberculosis infection and slow lesion changes. Conclusion CT inspection contributes to differentiate aspergillosis and pulmonary tuberculosis presenting with bilateral pulmonary multiple cavities, therefore, it was of great importance in clinical application value.