Leung A N, Brauner M W, Gamsu G, Mlika-Cabanne N, Ben Romdhane H, Carette M F, Grenier P
Department of Radiology, Hôpital Pitié-Salpétrière, Paris, France.
Radiology. 1996 Mar;198(3):687-91. doi: 10.1148/radiology.198.3.8628855.
To determine the differences in the computed tomographic (CT) appearance of pulmonary tuberculosis (TB) between patients with and patients without human immunodeficiency virus (HIV) infection.
CT scans and chest radiographs of 42 HIV-seropositive and 42 HIV-seronegative patients with pulmonary TB were reviewed. CD4 T-lymphocyte counts, measured in 40 seropositive patients, were at least 200 cells per microliter in 10 patients and were less that 200 cells per microliter in 30.
Seropositive patients had a higher prevalence of lymphadenopathy at chest radiography (P< .05). The seropositive patients had a lower prevalence of consolidation (P< .05), cavitation (P< .01), and postprimary pattern (P< .05) at CT. HIV-seropositive patients had a higher frequency of miliary (P< .01) and extrapulmonary disease (P< .001). Similar features of pulmonary TB were observed in seropositive patients with mild and severe immunosuppression.
HIV-seropositive patients had a lower prevalence of localized parenchymal disease and a higher prevalence of disseminated disease at CT.
确定感染人类免疫缺陷病毒（HIV）的肺结核（TB）患者与未感染HIV的肺结核患者在计算机断层扫描（CT）表现上的差异。
回顾了42例HIV血清学阳性和42例HIV血清学阴性的肺结核患者的CT扫描和胸部X线片。在40例血清学阳性患者中测量了CD4 T淋巴细胞计数，其中10例患者每微升至少200个细胞，30例患者每微升少于200个细胞。
血清学阳性患者在胸部X线片上淋巴结病的患病率较高（P <.05）。血清学阳性患者在CT上实变（P <.05）、空洞形成（P <.01）和原发性后模式（P <.05）的患病率较低。HIV血清学阳性患者粟粒性病变（P <.01）和肺外疾病（P <.001）的发生率较高。在轻度和重度免疫抑制的血清学阳性患者中观察到类似的肺结核特征。
HIV血清学阳性患者在CT上局部实质性疾病的患病率较低，播散性疾病的患病率较高。
