Objective To investigate the CT manifestations of solitary localized spherical pneumonia(SLSP)and its differential diagnostic value in order to improve the imaging diagnostic ability of the disease. Methods From August 2006 to January 2015,we collected the clinical data of 54 patients who were diagnosed as SLSP by surgery and pathology and accorded with inclusion and exclusion criteria from Kailuan Tangjiazhuang Hospital. CT manifestations of patients were observed and analyzed,including site,shape,margin,size,density,adjacent pleura changes,manifestations close to the hilus of lung, manifestations of the field adjacent to nidus. The dynamic changes after anti - inflammation therapy were also observed and analyzed. Results There were 38(70. 4% )patients who had nidus in the posterior basal segments and dorsal segments of the lower lobes;46(85. 2% )patients had wedge - shape nidus,including 34(73. 9% )patients with square - like nidus,9 (19. 6% )patients with hill - shape nidus and 3(6. 5% )patients with triangle - shape nidus. There were 41(75. 9% )patients who had coarse and long burrs and 13(24. 1% )patients who had vague ribbon - like low - density shadow which took on halo sign. The diameter of nidus was 2. 0 - 7. 5 cm,and the average diameter was 3. 9 cm. The density of nidus of 30(55. 6% ) patients was average. There were 48(88. 9% )patients who had nidus close to pleura,and 41 patients had even increase in the thickness of surrounding pleura. Localized hyperemia sign appeared in 30(55. 6% )patients,and 17(31. 5% )patients had slight increase in the bronchial wall corresponding to lesion;20(37. 0% )patients had small patchy oozing focus. There were 49 (90. 7% )patients who received anti - inflammation therapy;among them,47(95. 9% )patients saw symptoms relieve and disappear after anti - inflammation therapy,2 ( 4. 1% )patients had unfavorable treatment outcomes after antituberculosis therapy and then received anti - inflammation therapy which dissipated and absorbed nidi,and 5(9. 3% )patients received excision. Conclusion SLSP mainly locates in the lateral posterior basal segments and dorsal segments of the lower lobes,mostly being close to pleural surface and taking on the wedge or quasi - circular shape;the margins are mostly coarse long burrs or vague halo signs. Localized hyperemia signs appear in vessels and bronchia at the hilus of the lung,and small patchy inflammatory exudation appear. Patients with SLSP close to pleural surface are mostly with average increase in the thickness of pleura in a wider range. Combined with clinical and laboratory manifestations and observation of the dynamic changes of nidus,SLSP can be definitely diagnosed,and aspiration biopsy or thoracotomy can be conducted when there is difficulty in diagnosis.%目的：探讨单发局灶球形肺炎（SLSP）的 CT 表现特征及鉴别诊断价值，以进一步提高本病的影像诊断水平。方法搜集2006年8月—2015年1月于开滦（集团）有限责任公司唐家庄医院临床、手术病理证实且符合纳入与排除标准的54例 SLSP 患者的临床资料。观察并分析患者 CT 表现特征（包括病灶部位、形态、边缘、大小、密度，邻近胸膜改变，肺门侧表现，病灶侧缘肺野表现）及抗炎治疗后动态变化。结果 CT 表现特征：38例（70.4%）患者病灶部位为双肺下叶后外基底段及背段；46例（85.2%）患者病灶呈楔形，其中34例（73.9%）呈类方形征，9例（19.6%）呈山丘状，3例（6.5%）呈三角形；41例（75.9%）可见毛糙的长毛刺，13例（24.1%）肺窗周围为模糊的带状低密度影，呈晕征；病灶直径2.0~7.5 cm，平均病灶直径3.9 cm；30例（55.6%）病灶密度均匀；48例（88.9%）病灶与胸膜相贴，其中41例周围胸膜均匀性增厚；30例（55.6%） 显示局部充血征，17例（31.5%） 病变相对应支气管壁略增厚；20例（37.0%）病灶侧缘邻近肺野内可见小斑片状渗出灶。49例（90.7%）患者接受抗炎治疗，其中47例（95.9%）经抗炎治疗后症状减轻、消失，2例（4.1%）抗结核治疗效果不良，再行抗感染治疗病灶消散、吸收；5例（9.3%）手术切除。结论 SLSP 主要位于双肺下叶后外基底段或背段，以贴近胸膜面常见，表现为楔形或类圆形，边缘多为毛糙的长毛刺或模糊的晕征；可见肺门侧血管、支气管局部充血征，病灶侧缘的小片状炎性渗出表现。贴近胸膜者，胸膜以较广范围均匀性增厚居多。结合临床、实验室检查以及适时的病灶动态演变观察，多能够确诊 SLSP，鉴别困难时需穿刺活检或开胸探查。
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