Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan 602-739, Korea.
Br J Radiol. 2010 Mar;83(987):206-11. doi: 10.1259/bjr/95169618.
The aim of this study was to determine the differences in CT findings of miliary tuberculosis in patients with and without HIV infection. Two radiologists reviewed retrospectively the CT findings of 15 HIV-seropositive and 14 HIV-seronegative patients with miliary tuberculosis. The decisions on the findings were reached by consensus. Statistical analysis was performed using the chi2 test, Mann-Whitney U-test and Fisher's exact test. All of the HIV-seropositive and -seronegative patients had small nodules and micronodules distributed randomly throughout both lungs. HIV-seropositive patients had a higher prevalence of interlobular septal thickening (p = 0.017), necrotic lymph nodes (p = 0.005) and extrathoracic involvement (p = 0.040). The seropositive patients had a lower prevalence of large nodules (p = 0.031). In conclusion, recognition of the differences in the radiological findings between HIV-seropositive and -seronegative patients may help in the establishment of an earlier diagnosis of immune status in patients with miliary tuberculosis.
本研究旨在确定 HIV 感染患者与非 HIV 感染患者的血行播散性肺结核的 CT 表现差异。两位放射科医生回顾性分析了 15 例 HIV 血清阳性和 14 例 HIV 血清阴性的血行播散性肺结核患者的 CT 表现。通过共识达成对发现的决定。使用卡方检验、Mann-Whitney U 检验和 Fisher 确切检验进行统计学分析。所有 HIV 血清阳性和阴性的患者均有随机分布于双肺的小结节和微小结节。HIV 血清阳性患者的小叶间隔增厚(p = 0.017)、坏死性淋巴结(p = 0.005)和胸外受累(p = 0.040)的发生率较高。血清阳性患者的大结节发生率较低(p = 0.031)。总之,认识到 HIV 血清阳性和阴性患者的影像学表现差异可能有助于更早地诊断血行播散性肺结核患者的免疫状态。