Pulmonary Tuberculosis: Role of Radiology in Diagnosis and Management
| Autor: | Girish S. Shroff, Mark M. Hammer, Daniel Ocazionez, Kasra Rahbar, Sharyn I. Katz, Elizabeth Guy, Xiao Shi, Arun C. Nachiappan, Alan E Schlesinger, Eduardo J. Mortani Barbosa |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Tuberculosis business.industry Radiography MEDLINE Mycobacterium tuberculosis medicine.disease Bacterial Typing Techniques 030218 nuclear medicine & medical imaging Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Pulmonary tuberculosis health services administration medicine Humans Radiography Thoracic Radiology Nuclear Medicine and imaging 030212 general & internal medicine Radiology business Tuberculosis Pulmonary |
| Zdroj: | RadioGraphics. 37:52-72 |
| ISSN: | 1527-1323 0271-5333 |
| Popis: | Tuberculosis is a public health problem worldwide, including in the United States-particularly among immunocompromised patients and other high-risk groups. Tuberculosis manifests in active and latent forms. Active disease can occur as primary tuberculosis, developing shortly after infection, or postprimary tuberculosis, developing after a long period of latent infection. Primary tuberculosis occurs most commonly in children and immunocompromised patients, who present with lymphadenopathy, pulmonary consolidation, and pleural effusion. Postprimary tuberculosis may manifest with cavities, consolidations, and centrilobular nodules. Miliary tuberculosis refers to hematogenously disseminated disease that is more commonly seen in immunocompromised patients, who present with miliary lung nodules and multiorgan involvement. The principal means of testing for active tuberculosis is sputum analysis, including smear, culture, and nucleic acid amplification testing. Imaging findings, particularly the presence of cavitation, can affect treatment decisions, such as the duration of therapy. Latent tuberculosis is an asymptomatic infection that can lead to postprimary tuberculosis in the future. Patients who are suspected of having latent tuberculosis may undergo targeted testing with a tuberculin skin test or interferon-γ release assay. Chest radiographs are used to stratify for risk and to assess for asymptomatic active disease. Sequelae of previous tuberculosis that is now inactive manifest characteristically as fibronodular opacities in the apical and upper lung zones. Stability of radiographic findings for 6 months distinguishes inactive from active disease. Nontuberculous mycobacterial disease can sometimes mimic the findings of active tuberculosis, and laboratory confirmation is required to make the distinction. Familiarity with the imaging, clinical, and laboratory features of tuberculosis is important for diagnosis and management. |
| Databáze: | OpenAIRE |
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