Felix R, Bittner R C
Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin.
Pneumologie. 1995 Dec;49 Suppl 3:657-62.
The discovery of the x-rays by W. C. Roentgen 100 years ago significantly improved the diagnosis and follow-up of tuberculosis, therapy control became possible, and the basis for prevention was set by early detection. Within few years, the "Roentgen" rays had been made a triumphant progress around the world, and Roentgenology was established as an independent medical discipline. Even after a century of developments like tomography, ultrasound, conventional/-high resolution and spiral computed tomography, digital radiography, digital subtraction angiography, and magnetic resonance imaging, innovations in the field of medical imaging appear to be unlimited, an evolution, which had been initiated by Roentgen. Today, therapists and radiologists are again challenged by the renaissance of tuberculosis, partially in new "clothes" by increasing numbers of HIV-patients. These specific changes clinically and radiological often appear atypical, and require subtile radiological diagnostics with the use of new imaging modalities. CT and MRI allow for follow-up of chemotherapy in mediastinal lymph node disease, significantly improve pleural diagnosis, and both are methods of choice in vertebral and cerebral tuberculous disease. Digital radiography and digital net-work allow for x-rays at the lowest dose, improved comparison in the follow-up, as well as for "online"-evaluation of images on the department's screen. Today, optimal diagnosis of tuberculosis includes the bacteriologic and clinical diagnosis and radiological imaging. To face the challenge of recurrent tuberculosis in in the second century after after Roentgen successfully, an intensive interdisciplinary cooperation of therapists and radiologists is necessary.
100年前,W. C. 伦琴发现了X射线,这极大地改善了结核病的诊断和后续跟踪,使治疗控制成为可能,早期检测为预防奠定了基础。几年内,“伦琴”射线就在全球取得了巨大进展,伦琴射线学成为一门独立的医学学科。即使在经过了一个世纪的发展,如断层扫描、超声、传统/高分辨率和螺旋计算机断层扫描、数字放射摄影、数字减影血管造影以及磁共振成像之后,医学成像领域的创新似乎仍无极限,这一演变由伦琴发起。如今,治疗师和放射科医生再次受到结核病复兴的挑战,部分原因是感染艾滋病毒的患者数量增加,结核病呈现出新的“面貌”。这些在临床和放射学上的特定变化往往不典型,需要使用新的成像方式进行细致的放射学诊断。CT和MRI可用于纵隔淋巴结疾病化疗的后续跟踪,显著改善胸膜诊断,并且都是脊椎和脑结核疾病的首选方法。数字放射摄影和数字网络可实现最低剂量的X射线检查,改善后续跟踪中的对比效果,还能在科室屏幕上对图像进行“在线”评估。如今,结核病的最佳诊断包括细菌学、临床诊断和放射学成像。为了成功应对伦琴发现X射线后的第二个世纪中复发性结核病的挑战,治疗师和放射科医生之间进行深入的跨学科合作是必要的。