Abstract: Objective :To assess the accuracy of multi-slice spiral CT (MSCT) plus imaging recon-struction in judging central pulmonary vascular involvement from central lung cancer and to explore itsability in foreseeing the resectability of lung cancer. Methods :MSCT was done in 48 patients withcentral lung cancer diagnosed preoperatively.Images of pulmonary arteries and veins that might affectlobectomy or pneumonectomy were reconstructed by means of image processing techniques. Then therelation of tumor and vessels was assessed prospectively on both axial CT images and axial CT imagesplus reconstructed images (CT-RI) in comparison with subsequent pathologic and surgical findings. Results :MSCTs were obtained of all 48 patients, and 42 underwent thoracotomy, lobectomy or pneu-monectomy. Compared with axial CT images, CT-RI was more accurate in judging the relationship be-tween the central pulmonary vessels and the tumor, based on subsequent pathologic (78 vessels studied)and surgical findings (186 vessels studied) (0.01Conclusions:MSCT plus imagereconstruction can improve the recognition of neoplastic invasion of central pulmonary vessels.It can beused to foresee preoperatively the resectability of central lung cancer and to plan the surgical procedure.