Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, Brazil.
Respir Med. 2011 Jul;105(7):1079-83. doi: 10.1016/j.rmed.2011.02.014. Epub 2011 Mar 9.
To evaluate in chest X-rays and high-resolution computed tomographies of patients with pleural tuberculosis, the incidence of parenchymal and mediastinal lung lesions suggestive of active disease.
Prospective study (2008-2009) evaluating the radiographic and tomographic abnormalities of 88 HIV-negative patients with pleural tuberculosis (unilateral effusion). The images were reviewed by 3 independent specialists, and the observed changes were classified according to previously established criteria: presence or absence of signs suggestive of disease activity, and nonspecific findings.
Abnormal changes were observed in chest X-rays of 22 (25%) patients and in the computed tomography of 55 (63%). Images compatible with active pulmonary tuberculosis were detected by radiography in 9 (10%) patients and by tomography in 38 (43%). Only 4 (4.5%) patients had tomography images suggestive of residual disease.
The present study demonstrates that pulmonary involvement is quite common in pleural tuberculosis. This finding is mainly observed in high-resolution computed tomography and has important epidemiological implications, since patients with pleural tuberculosis are significant sources of infection and disease dissemination.
评估胸膜结核患者的 X 光胸片和高分辨率计算机断层扫描中提示活动性疾病的实质和纵隔肺部病变的发生率。
前瞻性研究（2008-2009 年）评估 88 例 HIV 阴性胸膜结核（单侧胸腔积液）患者的影像学和断层扫描异常。由 3 名独立专家对图像进行了审查，并根据先前建立的标准对观察到的变化进行了分类：是否存在提示疾病活动的征象，以及非特异性发现。
22 例（25%）患者的 X 光胸片和 55 例（63%）患者的计算机断层扫描显示异常改变。9 例（10%）患者的 X 光片和 38 例（43%）患者的计算机断层扫描显示符合活动性肺结核的影像学改变。只有 4 例（4.5%）患者的计算机断层扫描图像提示有残留疾病。
本研究表明，胸膜结核中肺部受累相当常见。这一发现主要在高分辨率计算机断层扫描中观察到，具有重要的流行病学意义，因为胸膜结核患者是重要的感染源和疾病传播源。
