目的：探讨结核性腹膜炎（ＴＰ） 与癌性腹膜炎（ ＣＰ） 的ＣＴ 鉴别诊断。材料与方法：搜集经手术病理及临床证实的ＴＰ１２ 例及经手术及病理证实的３４ 例ＣＰ 进行分析。结果：（１） ＴＰ 多表现为少量腹水（７／１０） ，高密度腹水（７／１０） ，ＣＰ常为大量腹水（２２／２９） ；（２） ＴＰ 壁腹膜多为光滑增厚（７／８） ，ＣＰ 为结节状增厚（２４／２４） ；（３） 肠系膜改变伴有环状增强的肿大淋巴结影为ＴＰ 的特征；（４） 大网膜饼形增厚多见于ＣＰ（８／３４） ，但ＴＰ 也可有此种表现（１／１２） ；（５） ＴＰ 液体局限性聚集常有囊壁，ＣＰ 囊状转移多无囊壁且伴肝脾外缘外压性改变。结论：ＣＴ 是鉴别ＴＰ 与ＣＰ 一较好的检查方法。 Objective: To explore the differential diagnosis of tuberculous peritonitis (TP) and malignant peritonitis (CT). Materials and Methods: Twenty cases of TP12 confirmed by operation and pathology and 34 cases of CP confirmed by operation and pathology were collected. Results: (1) TP showed mostly ascites (7/10), high density ascites (7/10), CP was often ascites (22/29); (2) / 8), CP nodular thickening (24/24); (3) mesenteric changes associated with ring enhancement of enlarged lymph nodes as TP features; (4) omental pancake thickening more common in CP (8/34), but TP can also have such performance (1/12); (5) TP liquid accumulation often confined wall, cystic cyst more than the non-cystic wall and with the outer edge of liver and spleen pressure change. Conclusion: CT is a better way to distinguish between TP and CP.