Radiological findings of extensively drug-resistant pulmonary tuberculosis in non-AIDS adults: comparisons with findings of multidrug-resistant and drug-sensitive tuberculosis.
Radiological findings of extensively drug-resistant pulmonary tuberculosis in non-AIDS adults: comparisons with findings of multidrug-resistant and drug-sensitive tuberculosis.
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DOI：
10.3348/kjr.2009.10.3.207
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发表时间：
2009-05
影响因子：
4.8
通讯作者：
Chung MJ
中科院分区：
文献类型：
--
作者：
Cha J;Lee HY;Lee KS;Koh WJ;Kwon OJ;Yi CA;Kim TS;Chung MJ
本研究旨在描述广泛耐药（XDR）肺结核（TB）的放射学表现，并将观察到的表现与非艾滋病患者的药物敏感（DS）和非XDR多药耐药（MDR）TB的表现进行比较。从1994年9月至2007年12月，53例MDR TB患者（男：女= 32：21;平均年龄38岁）和15例XDR TB非AIDS患者（男：女= 8：7;平均年龄36岁）入组研究。所有耐多药结核病患者均未接受治疗或接受抗结核治疗不足1个月。此外，所有XDR结核病患者要么没有接受抗结核治疗，要么只接受一线抗结核药物治疗。此外，141例连续DS TB患者（男：女= 79：62;平均年龄51岁）也入组研究进行比较。对三组患者的胸片、CT和人口统计学结果进行了回顾性分析和比较。对于XDR TB患者，最常见的影像学异常是结节（15/15例，100%）、网状结节密度（11/15，73%）、实变（9/15，60%）和空洞（7/15，47%），主要位于肺上部和中部。从X线片上可以看出，结节和磨玻璃样病变的发生率有显著差异（所有p < 0.001）（DS TB患者比MDR和XDR TB患者更常见）。对于CT的使用，发现多腔、结节和支气管扩张的频率存在显著差异（MDR和XDR TB患者更常见）（p = 0.001或p < 0.001）。与DS TB患者相比，MDR TB和XDR TB患者更年轻（p < 0.001）。影像学表现在耐多药结核和广泛耐多药结核患者之间无差异。通过观察抗酸杆菌（AFB）阳性痰的年轻患者的CT所示的多个空洞、结节和支气管扩张，可以提示存在MDR TB或XDR TB而不是DS TB。XDR TB和MDR TB患者的影像学表现无显着差异。
This study was designed to describe the radiological findings of extensively drug-resistant (XDR) pulmonary tuberculosis (TB) and to compare the observed findings with findings of drug-sensitive (DS) and non-XDR multidrug-resistant (MDR) TB in non-AIDS patients. From September 1994 to December 2007, 53 MDR TB patients (M:F = 32:21; mean age, 38 years) and 15 XDR TB non-AIDS patients (M:F = 8:7; mean age, 36 years) were enrolled in the study. All of the MDR TB patients had received no treatment or less than one month of anti-TB treatment. In addition, all XDR TB patients received either no anti-TB treatment or only first-line anti-TB drugs. In addition, 141 consecutive DS TB patients (M:F = 79:62; mean age, 51 years) were also enrolled in the study for comparison. Chest radiograph, CT and demographic findings were reviewed and were compared among the three patient groups. For patients with XDR TB, the most frequent radiographic abnormalities were nodules (15 of 15 patients, 100%), reticulo-nodular densities (11 of 15, 73%), consolidation (9 of 15, 60%) and cavities (7 of 15, 47%) that were located mainly in the upper and middle lung zones. As seen on radiographs, significant differences were found for the frequency of nodules and ground-glass opacity lesions (all p < 0.001) (more frequent in DS TB patients than in MDR and XDR TB patients). For the use of CT, significant differences (more frequent in MDR and XDR TB patients) were found for the frequency of multiple cavities, nodules and bronchial dilatation (p = 0.001 or p < 0.001). Patients with MDR TB and XDR TB were younger as compared to patients with DS TB (p < 0.001). Imaging findings were not different between patients with MDR TB and XDR TB. By observation of multiple cavities, nodules and bronchial dilatation as depicted on CT in young patients with acid-fast bacilli (AFB) positive sputum, the presence of MDR TB or XDR TB rather than DS TB can be suggested. There is no significant difference in imaging findings between patients with XDR TB and MDR TB.
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影响因子：
120.7
作者：
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通讯作者：
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影响因子：
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作者：
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