目的探讨下肺结核X线检查和CT检查的影像学诊断价值。方法回顾分析发生在下肺野的64例结核病例的CT及X线表现。结果下肺野结核以中青年多见,发热、咳嗽、咳痰、咯血为其主要症状;其影像学表现多样:可以表现为大片实变为主、小叶片状渗出性病灶为主、空洞病灶为主及肿块病灶为主型改变,但常伴有增殖、纤维性病灶、“卫星”灶和同侧或对侧支气管播散病灶。CT检查较X线敏感,肿块型结核病灶增强扫描无强化或仅为环形强化。结论下肺野结核尽管临床症状资料不典型,但大部分病灶仍有其一定的影像学特征,仔细分析阅片,提高对本病的警惕性,注意鉴别诊断,可明显提高诊断的正确率。 Objective To investigate the diagnostic value of X-ray and CT examination of pulmonary tuberculosis. Methods The CT and X-ray findings of 64 tuberculosis cases in the lower lung field were retrospectively analyzed. Results The lower lung tuberculosis was more common in middle-aged and young people. Fever, cough, expectoration and hemoptysis were the main symptoms of the disease. The imaging manifestations were diverse: the lesions mainly consisted of large solidified and lobular exudative lesions, Mainly lesions and lump lesions mainly change, but often accompanied by proliferation, fibrosis, “satellite” and ipsilateral or contralateral bronchial lesions. CT examination is more sensitive than X-ray, mass-type tuberculosis enhanced scan without enhancement or only ring enhancement. Conclusions Although the clinical data of the tuberculosis of the lower lungs are not typical, most of the lesions still have some imaging features. By carefully analyzing the radiographs and improving the vigilance of the disease, paying attention to the differential diagnosis can obviously improve the accuracy of the diagnosis.