目的 分析周围型肺癌与局灶性 机化性肺炎的CT影像特点及鉴别价值。方 法 选取经手术病理证实的80例周围型肺 癌患者和60例局灶性机化性肺炎患者， 分别设为肺癌组、肺炎组。均在术前行 CT检查，对两组影像学资料进行统计学 分析，比较两组CT影像特点。结果 肺癌 组病灶部位左或右肺上叶例数、边缘清 晰、深分叶、长细毛刺征、纵隔淋巴结肿 大、瘤体显示例数所占百分比均显著高于 肺炎组（P＜0.05），病灶部位左或右肺 上叶例数与左或右肺下叶、短毛刺征、边 缘模糊、紧贴胸膜、液化、坏死、局部胸 膜增厚例数所占百分比均显著低于肺炎组 （P＜0.05），即两组影像学病灶部位、 形态、密度、分叶、毛刺及是否紧贴胸 膜、支气管充气征、局部胸膜增厚、纵隔 淋巴结肿大、有无纵隔瘤体显示有统计学 意义（P＜0.05）；肺癌组增强CT增加值 明显低于肺炎组（P＜0.05），两组其它 征象比较无统计学意义（P＞0.05）。结 论 周围型肺癌与局灶性机化性肺炎CT征 象及强化均有一定的差异性及特征性，可 从病灶部位、形态、密度、分叶、毛刺及 有无支气管充气征、局部胸膜增厚、纵隔 淋巴结肿大、瘤体显示等方面进行鉴别诊 断。

Objective To analyze the CT imaging features of peripheral lung cancer and focal organizing pneumonia and their differential diagnostic value. Methods A total of 80 patients with peripheral lung cancer and 60 patients with focal organizing pneumonia confirmed by surgery and pathology were selected and they were included into the lung cancer group (n=80) and pneumonia group (n=60) respectively. CT examination was performed before operation, and the imaging data of two groups were statistically analyzed. CT imaging features were compared between the two groups. Results The proportions of cases with lesions in the left or right upper lobe, clear margins, deep lobulated and long and thin spicule sign, mediastinal lymph node enlargement and displayed tumors in the lung cancer group were significantly higher than those in the pneumonia group (P<0.05), while the proportions of cases with lesions in left or right upper lobe of lung, left or right lower lobe, short spicule sign, blurred margins, close to the pleura, liquefaction, necrosis and local pleural thickening were significantly lower than those in the pneumonia group (P <0.05). Namely, there were statistically significant differences between the two groups in the imaging site, shape, density, lobulation, spicule, whether close to the pleura, bronchial congestion sign, local pleural thickening, mediastinal lymph node enlargement and display of tumors (P<0.05). The value added of enhanced CT in lung cancer group was significantly lower than that in pneumonia group (P<0.05), but there was no significant difference between the two groups in other signs (P>0.05). Conclusion CT signs and enhancement of peripheral lung cancer and focal organizing pneumonia are different and characteristic, and differential diagnosis can be performed from perspectives of the location, shape, density, lobulation, spicule, air bronchogram, local pleural thickening, mediastinal lymph node enlargement and display of tumors.