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结核病——极具伪装性的疾病。

Tuberculosis--the great mimicker.

作者信息

Prapruttam Duangkamon, Hedgire Sandeep S, Mani Sunithi Elizabeth, Chandramohan Anuradha, Shyamkumar N K, Harisinghani Mukesh

机构信息

Division of Abdominal Imaging and Intervention, Massachusetts General Hospital-Harvard Medical School, Boston, MA.

Division of Abdominal Imaging and Intervention, Massachusetts General Hospital-Harvard Medical School, Boston, MA.

出版信息

Semin Ultrasound CT MR. 2014 Jun;35(3):195-214. doi: 10.1053/j.sult.2014.02.002. Epub 2014 Feb 12.

Abstract

Tuberculosis is an immense health problem in the developing world, and it remains a health care challenge in the developed world. It can affect virtually any organ system in the body. Diagnosis of tuberculosis is often difficult. Many patients with tuberculosis present with nonspecific symptoms, negative purified protein derivative skin test result, and negative findings on culture specimens. Cross-sectional imaging with ultrasound, multidetector computed tomography, and magnetic resonance imaging plays an important role in the diagnosis of tuberculosis. Tuberculosis demonstrates a variety of radiologic features depending on the organ involved and can mimic a number of other disease entities. Cross-sectional imaging alone is insufficient in reaching a conclusive diagnosis. Tuberculosis is a great mimicker as its radiologic manifestations can simulate numerous other diseases across the body systems. However, recognition and understanding of the common and uncommon radiologic manifestations of tuberculosis should alert considering tuberculosis in the high-risk population and correct clinical setting to enable appropriate treatment.

摘要

结核病在发展中世界是一个严重的健康问题,在发达世界仍是一个医疗保健挑战。它几乎可以影响身体的任何器官系统。结核病的诊断往往很困难。许多结核病患者表现为非特异性症状、结核菌素皮肤试验结果阴性以及培养标本检查结果阴性。超声、多排螺旋计算机断层扫描和磁共振成像等横断面成像在结核病诊断中发挥着重要作用。根据受累器官的不同,结核病表现出多种放射学特征,并且可以模仿许多其他疾病实体。仅靠横断面成像不足以做出确定性诊断。结核病极具迷惑性,因为其放射学表现可模拟全身各系统的众多其他疾病。然而,认识和了解结核病常见和不常见的放射学表现,应促使在高危人群和正确的临床背景下考虑结核病,以便进行适当治疗。

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