目的　探讨成人原发型肺结核并具有原发综合征的CT特点 ,提高对该病的诊断水平。方法　回顾性分析 3 9例经临床确诊的原发型肺结核并具有原发综合征患者的CT资料 ,其中肺内病变局部行高分辨率CT扫描 ,3 0例行增强CT扫描。结果　肺内原发病灶位于右肺 2 5例 (64 1% ) ,左肺 14例 (3 5 9% )。表现为小叶实变或斑片、结节影者 2 8例 (71 8% ) ,扇形肺叶或肺段实变者 11例(2 8 2 % )。 2 6例合并其他肺叶支气管播散病灶。 96 3 % (3 7例 )的患者表现为多组淋巴结肿大 ,2R、4R和 7区多见。 3 0例增强扫描示 ,肿大淋巴结有 4种强化方式 ,均匀强化 10例、环行强化 2 0例、多灶性分隔样强化 18例和淋巴结破溃 4例 ,13例有两种以上强化方式 ;14例可见区域淋巴结粘连成团 ,增强后粘连的淋巴结可有不同强化方式。结论　肺内炎症浸润合并肺门、纵隔淋巴结肿大是原发综合征的基本特征。支气管播散病灶及淋巴结强化特征有助于鉴别诊断 Objective To explore the CT features of primary pulmonary tuberculosis in adults with primary syndrome and to improve the diagnosis of the disease. Methods The CT data of 39 clinically diagnosed patients with primary pulmonary tuberculosis and primary syndrome were retrospectively analyzed. High-resolution CT scans were performed locally in the lung and 30 enhanced CT scans were performed. Results The primary lung lesions were located in 25 cases (64 1%) in the right lung and 14 cases (19 59%) in the left lung. There were 28 cases (71.8%) of nodules and 11 cases (28.2%) of scleral lobe or consolidation of lung segments. 26 cases with other lobular bronchial disseminated lesions. 96 3% (37 cases) of patients showed multiple groups of lymph nodes, 2R, 4R and 7 more common. 30 cases of enhanced scan showed that the enlarged lymph nodes have four kinds of intensification, uniform enhancement in 10 cases, 20 cases of ring enhancement, multifocal septa-like enhancement in 18 cases and 4 cases of rupture of lymph nodes, 13 cases of two or more enhanced mode ; 14 cases of regional lymph node adhesions into the group, enhanced adhesion of lymph nodes may have different ways to strengthen. Conclusions Inflammatory pulmonary infiltrates combined with hilar and mediastinal lymph nodes are the basic features of the primary syndrome. Bronchial disseminated lesions and lymph node enhancement features contribute to the differential diagnosis