Hantous-Zannad S, Zidi A, Néji H, Attia M, Baccouche I, Ben Miled-M'rad K
Service d'imagerie médicale, hôpital Abderrahmane Mami, Ariana, Tunisie.
Service d'imagerie médicale, hôpital Abderrahmane Mami, Ariana, Tunisie.
Rev Pneumol Clin. 2015 Apr-Jun;71(2-3):93-109. doi: 10.1016/j.pneumo.2014.02.006. Epub 2014 May 27.
Tuberculosis is an infectious disease mostly due to Mycobacterium tuberculosis. It is frequent in developing countries and its incidence is rising in developed countries. Lungs are the most involved organs of the chest but other structures can be affected. Imaging is fundamental in the management of the disease. Confirmation of diagnosis can be made only by bacteriologic and/or histologic exams. The first approach of diagnosis is based on clinical symptoms and chest X-ray signs. Radiologic signs depend on patient's age, his immune status and his previous contact with M. tuberculosis. Conventional chest X-ray remains the first-line exam to realize. It can suggest the diagnosis on the appearance and location of the lesions. CT scan is recommended for the positive diagnosis in case of discrepancy between clinical and radiographic signs, as for the diagnosis of parenchymal, vascular, lymph nodes, pleural, parietal or mediastinal complications. It is also essential for the evaluation of parenchyma sequelae. MRI and PET-scan have limited indications. The purpose of this article is to illustrate different radiological forms of chest tuberculosis, its sequelae and complications and to highlight the role of each imaging technique in the patient's management.
结核病是一种主要由结核分枝杆菌引起的传染病。它在发展中国家很常见，在发达国家其发病率也在上升。肺部是胸部最常受累的器官，但其他结构也可能受到影响。影像学检查在该疾病的管理中至关重要。只有通过细菌学和/或组织学检查才能确诊。诊断的首要方法基于临床症状和胸部X线征象。放射学征象取决于患者的年龄、免疫状态以及既往与结核分枝杆菌的接触情况。常规胸部X线检查仍是首要的检查手段。它可根据病变的表现和位置提示诊断。当临床症状与放射学征象不一致时，或用于诊断实质、血管、淋巴结、胸膜、胸壁或纵隔并发症时，推荐进行CT扫描以明确诊断。它对于评估实质后遗症也至关重要。MRI和PET扫描的应用指征有限。本文旨在阐述胸部结核病的不同放射学表现、后遗症及并发症，并强调每种影像学技术在患者管理中的作用。
