Li Duo, He Wei, Chen Budong, Lv Pingxin
Department of Radiology, Beijing Chest Hospital of Capital Medical University, Tong Zhou District, Beijing, PR China.
PLoS One. 2017 Jun 6;12(6):e0176354. doi: 10.1371/journal.pone.0176354. eCollection 2017.
Multidrug-resistant tuberculosis has emerged as a global threat. The aim of this work was to compare the CT findings of primary multidrug-resistant tuberculosis and drug-sensitive tuberculosis in non-AIDS adults.
From January 2012 to February 2016, 89 patients with primary multidrug-resistant tuberculosis were retrospectively reviewed, and 89 consecutive drug sensitive TB patients with no history of anti-tuberculous chemotherapy from January 2014 to November 2014 were enrolled as control group. All patients were seronegative for HIV. The patients' demographic data and the locations, frequency and patterns of lung lesions on chest CT were compared.
Gender and frequency of diabetes were similar between the two groups. The mean age of primary multidrug-resistant tuberculosis patients was younger than that of drug-sensitive tuberculosis (39.0 vs 47.5, P = 0.005). Lung cavitary nodules or masses were more frequently observed and also showed greater extent in primary multidrug-resistant tuberculosis compared with drug-sensitive tuberculosis. The extent of bronchiectasis was significantly greater in primary multidrug-resistant tuberculosis than in drug-sensitive tuberculosis. Calcification, large nodules and calcified lymph nodes were more frequent in drug-sensitive tuberculosis.
Characteristic chest CT findings may help differentiate between primary multi-drug resistant tuberculosis and drug-sensitive tuberculosis in patients without HIV infection.
耐多药结核病已成为全球威胁。本研究的目的是比较非艾滋病成年患者原发性耐多药结核病和药物敏感结核病的CT表现。
回顾性分析2012年1月至2016年2月期间89例原发性耐多药结核病患者,并将2014年1月至2014年11月期间89例无抗结核化疗史的连续药物敏感结核病患者作为对照组。所有患者HIV血清学检查均为阴性。比较两组患者的人口统计学数据以及胸部CT上肺部病变的位置、频率和模式。
两组患者的性别和糖尿病发病率相似。原发性耐多药结核病患者的平均年龄低于药物敏感结核病患者(39.0对47.5,P = 0.005)。与药物敏感结核病相比,原发性耐多药结核病患者肺部空洞结节或肿块的观察频率更高,范围也更大。原发性耐多药结核病患者的支气管扩张程度明显大于药物敏感结核病患者。钙化、大结节和钙化淋巴结在药物敏感结核病中更为常见。
特征性胸部CT表现可能有助于鉴别未感染HIV患者的原发性耐多药结核病和药物敏感结核病。