Our study investigated the relationships between tumors and surrounding structures, particularly vessels and bronchi within lesions in the periphery of the lung. We performed axial multiplanar reconstruction CT (AMPR-CT) with a Toshiba TCT-900S scanner, as well as conventional CT (Conv. CT) and CR tomography (CR tomo.). We examined 19 patients with pulmonary lesions who later underwent surgical resection (12 with lung cancer, 1 with metastatic tumor, 1 with hamartoma, 2 with tuberculoma, and 3 with pulmonary granuloma) of a total of 43 patients with small nodular lesions less than 3 cm in diameter. AMPR-CT, Conv. CT, and CR tomo. were compared against resected specimens. The accuracy of each modality to detect involvement of bronchus, the pulmonary artery, and vein was AMPR-CT 50%:93%:91%, Conv. CT 47%:76%:55% and CR tomo. 37%:55%:42%, respectively. AMPR-CT was judged superior to both Conv. CT and CR tomo. In conclusions: 1) That AMPR-CT permits easier visualization of vessels and bronchi, and 2) That AMPR-CT is more effective than Conv. CT examinations in the morphological assessment of small nodular lesions. Thus, AMPR-CT is a useful new approach to the diagnosis of lesions in the lung.