Email Alert | RSS

Chinese Journal of Antituberculosis ›› 2023, Vol. 45 ›› Issue (2): 159-164.doi: 10.19982/j.issn.1000-6621.20220401

• Original Articles • Previous Articles     Next Articles

Analysis of atypical chest CT findings in AIDS patients complicated with pulmonary tuberculosis

Du Yanni1, Xue Ming1, Guan Chunshuang1, Xing Yuxue1, Chen Budong2, Xie Ruming1()   

  1. 1Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
    2Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
  • Received:2022-10-14 Online:2023-02-10 Published:2023-02-01
  • Contact: Xie Ruming E-mail:mingruxie1@sina.com
  • Supported by:
    Beijing Health Science and Technology Achievements and Appropriate Technology Promotion Project(2020-TG-001)

Abstract:

Objective: To analyze the chest CT features of AIDS patients complicated with pulmonary tuberculosis (PTB), so as to improve the diagnostic value of imaging. Methods: One hundred and seventy-one AIDS patients only complicated with PTB from Beijing Ditan Hospital, Capital Medical University were retrospectively collected. The diagnosis was confirmed by pathology, laboratory examination or clinical diagnosis from January 2017 to January 2020. The type, distribution, morphology and changes of chest CT were analyzed. Results: Among the 171 patients, 117 (68.4%) had multiple types of PTB, and the incidence of secondary PTB combined with intrathoracic lymph node PTB was the highest (n=74, 43.3%). Of the 117 secondary PTB patients, 37 cases (31.6%) were located at the predilection site, 25 cases (21.4%) were located at the non predilection and atypical sites, and 55 cases (47.0%) were located at both the predilection and non predilection sites. The imaging signs were mainly bronchial dissemination (n=85, 72.6%), consolidation (n=79, 67.5%) and multiple nodules (n=78, 66.7%); 31 cases (39.2%) showed exudative consolidation similar to pneumonia without satellite lesions around. Among 53 cases of hematogenous disseminated PTB, 45 cases (84.9%) showed “three homogeneous” miliary nodules. Among 107 cases of intrathoracic lymph node TB, 31 cases (29.0%) had ulceration and invasion of adjacent pulmonary parenchyma, 23 cases (21.5%) had focal fusion, and 5 cases (4.7%) had gas signs in the lymph nodes. The incidence of TB pleurisy and associated pericardial effusion was high (36.3%, 62/171). The average time of CT re-examination in 139 cases after anti-tuberculosis drug treatment was 17 days, PTB lesions were absorbed in 52 cases (37.4%), while 58 cases (41.7%) had progressed. Conclusion: AIDS complicated with PTB often showed multiple types of PTB. The lesions were extensive and had no dominant distribution; the proportion of consolidation lesions similar to pneumonia was high; intrathoracic lymph nodes TB might have rare signs of gas; non-“three homogeneous” hematogenous disseminated PTB was common; the lesions changed rapidly in a short time after anti-TB treatment.

Key words: Tuberculosis, pulmonary, Acquired immunodeficiency syndrome, Superinfection, Radiographic image interpretation, computer-assisted, Diagnostic imaging

CLC Number: