Burrill Joshua, Williams Christopher J, Bain Gillian, Conder Gabriel, Hine Andrew L, Misra Rakesh R
Department of Radiology, Central Middlesex Hospital, London, England, UK.
Radiographics. 2007 Sep-Oct;27(5):1255-73. doi: 10.1148/rg.275065176.
Tuberculosis has shown a resurgence in nonendemic populations in recent years, a phenomenon that has been attributed to factors such as increased migration and the human immunodeficiency virus epidemic. Although the thorax is most frequently involved, tuberculosis may involve any of a number of organ systems (eg, the respiratory, cardiac, central nervous, musculoskeletal, gastrointestinal, and genitourinary systems), and timely diagnosis of the disease is paramount, since delayed treatment is associated with severe morbidity. Unfortunately, a history of infection with or exposure to tuberculosis may or may not be present, and evidence of active tuberculosis is present in less than 50% of cases. A negative tuberculin skin test does not in itself exclude infection. Furthermore, the clinical and radiologic features of tuberculosis may mimic those of many other diseases. Therefore, although in many cases biopsy or culture specimens are required to make the definitive diagnosis, it is imperative that radiologists and clinicians understand the typical distribution, patterns, and imaging manifestations of tuberculosis.
近年来，结核病在非流行人群中呈再度流行趋势，这一现象归因于移民增加和人类免疫缺陷病毒流行等因素。尽管胸部最常受累，但结核病可能累及多个器官系统中的任何一个（如呼吸系统、心脏、中枢神经系统、肌肉骨骼系统、胃肠道和泌尿生殖系统），及时诊断该病至关重要，因为延迟治疗会导致严重的发病率。不幸的是，可能存在或不存在结核感染或接触史，且不到50%的病例有活动性结核病的证据。结核菌素皮肤试验阴性本身并不能排除感染。此外，结核病的临床和放射学特征可能与许多其他疾病相似。因此，尽管在许多情况下需要活检或培养标本才能做出明确诊断，但放射科医生和临床医生必须了解结核病的典型分布、模式和影像学表现。
