摘要:

Fifty-six consecutive symptomatic patients with AIDS referred for gallium scintigraphy were prospectively studied with chest high-resolution computed tomography (HRCT). Results of gallium and HRCT were correlated with findings of bronchoscopy or clinical follow-up for 1 month from time of discharge. Twenty-two patients were eventually diagnosed with at least one of the following:Pneumocystis carinii,cytomegalovirus,Mycobacterium aviumcomplex, bacteria, Kaposi's sarcoma, or lymphocytic interstitial pneumonitis. HRCT was more sensitive (82%) and more specific (91%) than gallium (59% and 75%, respectively). HRCT yielded higher positive predictive values (86%) and negative predictive values (88%) than did gallium (62% and 73%, respectively). HRCT was more helpful in guiding the method of biopsy and directing the brochoscopist to the diseased lung segment that would maximize diagnostic yield

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

To compare findings of active pulmonary tuberculosis on computed tomography (CT) and high-resolution computed tomography (HRCT) scans in patients without the human immunodeficiency virus (HIV) and patients with HIV, and to define the spectrum of pulmonary tuberculosis in patients with HIV according to the CD4 T cell status, 76 patients (47 patients without HIV and 29 patients with HIV) with newly diagnosed pulmonary tuberculosis were studied retrospectively. The diagnosis of active pulmonary tuberculosis was based on acid-fast bacilli (AFB) in sputum culture. All patients underwent CT within 1 month of diagnosis. Patients with HIV demonstrated significantly less cavitation and bronchial wall thickening (24% vs. 49% [p < 0.05]; and 14% vs. 45% [p < 0.01], respectively) than the combined group of patients with HIV. Centrilobular nodules were significantly less common in patients without HIV (14% vs. 45%, p < 0.05). Lymphadenopathy with low attenuation centers was significantly less frequent in the patients with HIV (3% vs. 15%, p < 0.05). In patients with HIV, cavitation, lymphadenopathy, as well as the the number of nodules and the number of lobes involved correlated well with the CD4 levels. Two patients with less than 50 CD4 T cells/mm3had normal chest CT results. Atypical chest CT patterns are frequently encountered in patients with HIV. Knowledge of these CT patterns may assist in the diagnosis and follow-up of patients with HIV with known or suspected pulmonary tuberculosis.

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Multidrug-resistant tuberculosis (MDR TB) is prevalent in urban areas with large HIV-positive populations. We retrospectively evaluated the chest radiographs of MDR TB patients at presentation and compared them to patients with drug-sensitive tuberculosis (DS TB). Although the overall radiographic findings and patterns of MDR TB and DS TB were similar, there were significant differences among the MDR TB patients depending on how MDR TB was acquired. Patients who developed MDR TB during an outbreak showed noncavitary consolidations, pleural effusions, and a primary radiographic pattern (70%). On the other hand, patients who acquired MDR TB due to noncompliance with antituberculous therapy often had cavitary consolidations (50%) and generally demonstrated a postprimary radiographic pattern. Cavitation occurred equally in patients with MDR TB who are HIV positive regardless of CD4 cell count. Chest radiographic findings and patterns in MDR TB are most accurately interpreted in conjunction with clinical history, specifically prior TB treatment. Nevertheless, approximately one-third of patients did not show the “expected” radiographic pattern.

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID