Radiological Findings of Primary Multidrug-resistant Pulmonary Tuberculosis in HIV-seronegative Patients
SH Kim, JH Min, JY Lee
Hong Kong J Radiol 2014;17:4-8
DOI: 10.12809/hkjr1413213
Objective: To compare the computed tomography findings of patients with primary multidrug-resistant tuberculosis (MDR TB) and those with drug-sensitive tuberculosis (DS TB) who were human immunodeficiency virus (HIV) seronegative.
Methods: The computed tomography findings of 40 patients with MDR TB and 40 with DS TB were retrospectively reviewed. The presence of centrilobular nodules, consolidation, cavity, bronchiectasis, calcification, pleural effusion, lymphadenopathy, laterality and number of involved lobes were looked for. Statistical comparison entailed the use of Student’s T test, the Chi-square test, and the Mann-Whitney U test.
Results: Cavities were more frequently observed in patients with primary MDR TB than those with DS TB (p = 0.007), and when present, these were more numerous in the former patients than in the latter (p = 0.001). There was no statistically significant difference between primary MDR TB and DS TB in terms of centrilobular nodules, consolidation, bronchiectasis, calcification, pleural effusions, lymphadenopathy, laterality, and number of involved lobes.
Conclusions: In HIV-seronegative patients, the presence of multiple cavities was a significantly more common computed tomography finding in the MDR TB patients than in the DS TB patients. This computed tomography finding may enable early detection and appropriate therapy for such infected patients, as it can be obtained rapidly.
中文摘要
HIV血清反應陰性患者中原發性多重耐藥性肺結核的的影像學表現
SH Kim、JH Min、JY Lee
目的：比較人類免疫缺陷病毒（HIV）血清反應陰性的原發性多重耐藥性肺結核（MDR TB）患者和藥物敏感性肺結核（DS TB）患者電腦斷層掃描的結果。
方法：將40例MDR TB和40例DS TB的電腦斷層掃描結果進行回顧分析。從掃描結果中尋找出小葉中心型結節、實變、空洞、支氣管擴張、鈣化、胸腔積液、淋巴結腫大、偏側性和受累肺葉數目。使用Student’s T檢驗、卡方檢驗和Mann-Whitney U檢驗進行統計比較。
結果：原發性MDR TB患者空洞發生率高於DS TB患者（p = 0.007）；且一經發生，前者空洞數目多於後者（p = 0.001）。在小葉中心型結節、實變、支氣管擴張、鈣化、胸腔積液、淋巴結腫大、偏側性和受累肺葉數目方面，兩組患者並無統計學顯著差異。
結論：在HIV血清反應陰性的患者中，MDR TB患者電腦斷層掃描結果中多發性空洞發生率顯著高於DS TB患者。由於電腦斷層掃描結果可以快速獲取，使該方法能讓這類感染患者得到早期檢測及適當治療。