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Der Radiologe

, Volume 47, Issue 5, pp 393–400 | Cite as

Radiologische Diagnostik der Lungentuberkulose

  • E. EisenhuberEmail author
  • G. Mostbeck
  • A. Bankier
  • A. Stadler
  • R. Rumetshofer
Leitthema: Interstitielle Lungenerkrankungen

Zusammenfassung

Das Kennen und Erkennen charakteristischer Tuberkulose-assoziierter Lungenveränderungen stellt einen Grundpfeiler in der Diagnostik der Tuberkulose dar. Neben dem Thoraxröntgen spielt die Computertomographie bei der Lungentuberkulose eine zunehmend wichtigere Rolle, da sie wesentlich sensitiver beim Nachweis von Kavernen, einer hilären und mediastinalen Lymphadenopathie, von Streuherden und Komplikationen der Tuberkulose ist. Die Computertomographie erlaubt die Beurteilung einer Aktivität speziell bei negativem Nachweis der Mykobakterien im Sputum und bei multiresistenter Tuberkulose. Die Tuberkulose kann in Abhängigkeit von der Immunlage des Patienten ein sehr unterschiedliches Erscheinungsbild haben. Die frühzeitige Diagnose und Therapie sind entscheidend, um eine weitere Ausbreitung zu verhindern.

Schlüsselwörter

Tuberkulose Lunge Diagnostik Computertomographie (CT) 

Radiologic diagnosis of lung tuberculosis

Abstract

The radiologic knowledge of tuberculosis-associated lung disease is an essential tool in the clinical diagnosis of tuberculosis. Chest radiography is the primary imaging method, but the importance of CT is still increasing, as CT is more sensitive in the detection of cavitation, of hilar and mediastinal lymphadenopathie, of endobronchial spread and of complications in the course of the disease. In addition, CT has been proven as a valuable technique in the assessment of tuberculosis activity, especially in patients where M. tuberculosis has not been detected in the sputum or in patients with multidrug-resistant tuberculosis. Depending on the immune status of the patient, the morphologic spectrum of tuberculosis is quite variable. Early diagnosis of tuberculosis is essential to prevent further spread of the disease.

Keywords

Tuberculosis Lung Diagnosis Computed tomography (CT) 

Notes

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Literatur

  1. 1.
    Chan ED, Laurel V, Strand MJ et al. (2004) Treatment and outcome analysis of 205 patients with multidrug-resistant tuberculosis. Am J Respir Crit Care Med 169: 1103–1109CrossRefPubMedGoogle Scholar
  2. 2.
    Choi D, Lee KS, Suh GY et al. (1999) Pulmonary tuberculosis presenting as acute respiratory failure: radiologic findings. J Comput Assist Tomogr 23: 107–113CrossRefPubMedGoogle Scholar
  3. 3.
    Choyke PL, Sostman HD, Curtis AM et al. (1983) Adult-onset pulmonary tuberculosis. Radiology 148: 357–362PubMedGoogle Scholar
  4. 4.
    Collins J, Blankenbaker D, Stern EJ (1998) CT patterns of bronchiolar disease: what is „tree-in-bud“? AJR Am J Roentgenol 171: 365–370PubMedGoogle Scholar
  5. 5.
    Davis SD, Yankelevitz DF, Williams T, Henschke CI (1993) Pulmonary tuberculosis in immunocompromised hosts: epidemiological, clinical, and radiological assessment. Semin Roentgenol 28: 119–130CrossRefPubMedGoogle Scholar
  6. 6.
    Goodman PC (1995) Tuberculosis and AIDS. Radiol Clin North Am 33: 707–717PubMedGoogle Scholar
  7. 7.
    Greenberg SD, Frager D, Suster B et al. A (1994) Active pulmonary tuberculosis in patients with AIDS: spectrum of radiographic findings (including a normal appearance). Radiology 193: 115–119PubMedGoogle Scholar
  8. 8.
    Haramati LB, Choi Y, Widrow CA, Austin JH (1996) Isolated lymphadenopathy on chest radiographs of HIV-infected patients. Clin Radiol 51: 345–349CrossRefPubMedGoogle Scholar
  9. 9.
    Harisinghani MG, McLoud TC, Shepard JA et al. (2000) Tuberculosis from head to toe. Radiographics 20: 449–470; quiz 528–449, 532PubMedGoogle Scholar
  10. 10.
    Hatipoglu ON, Osma E, Manisali M et al. (1996) High resolution computed tomographic findings in pulmonary tuberculosis. Thorax 51: 397–402PubMedGoogle Scholar
  11. 11.
    Hong SH, Im JG, Lee JS et al. (1998) High resolution CT findings of miliary tuberculosis. J Comput Assist Tomogr 22: 220–224CrossRefPubMedGoogle Scholar
  12. 12.
    Im JG, Itoh H, Han MC (1995) CT of pulmonary tuberculosis. Semin Ultrasound CT MR 16: 420–434CrossRefPubMedGoogle Scholar
  13. 13.
    Im JG, Itoh H, Lee KS, Han MC (1995) CT-pathology correlation of pulmonary tuberculosis. Crit Rev Diagn Imaging 36: 227–285PubMedGoogle Scholar
  14. 14.
    Kim HY, Song KS, Goo JM et al. (2001) Thoracic sequelae and complications of tuberculosis. Radiographics 21: 839–858; discussion 859–860PubMedGoogle Scholar
  15. 15.
    Kim WS, Choi JI, Cheon JE et al. (2006) Pulmonary tuberculosis in infants: radiographic and CT findings. AJR Am J Roentgenol 187: 1024–1033CrossRefPubMedGoogle Scholar
  16. 16.
    Kim YI, Goo JM, Kim HY et al. (2001) Coexisting bronchogenic carcinoma and pulmonary tuberculosis in the same lobe: radiologic findings and clinical significance. Korean J Radiol 2: 138–144PubMedGoogle Scholar
  17. 17.
    Krysl J, Korzeniewska-Kosela M, Muller NL, FitzGerald JM (1994) Radiologic features of pulmonary tuberculosis: an assessment of 188 cases. Can Assoc Radiol J 45: 101–107PubMedGoogle Scholar
  18. 18.
    Kwong JS, Carignan S, Kang EY et al. (1996) Miliary tuberculosis. Diagnostic accuracy of chest radiography. Chest 110: 339–342PubMedGoogle Scholar
  19. 19.
    Lee KS, Hwang JW, Chung MP et al. (1996) Utility of CT in the evaluation of pulmonary tuberculosis in patients without AIDS. Chest 110: 977–984PubMedGoogle Scholar
  20. 20.
    Lee KS, Im JG (1995) CT in adults with tuberculosis of the chest: characteristic findings and role in management. AJR Am J Roentgenol 164: 1361–1367PubMedGoogle Scholar
  21. 21.
    Leung AN (1999) Pulmonary tuberculosis: the essentials. Radiology 210: 307–322PubMedGoogle Scholar
  22. 22.
    Leung AN, Muller NL, Pineda PR, FitzGerald JM (1992) Primary tuberculosis in childhood: radiographic manifestations. Radiology 182: 87–91PubMedGoogle Scholar
  23. 23.
    McAdams HP, Erasmus J, Winter JA (1995) Radiologic manifestations of pulmonary tuberculosis. Radiol Clin North Am 33: 655–678PubMedGoogle Scholar
  24. 24.
    Miller WT, Miller WT jr (1993) Tuberculosis in the normal host: radiological findings. Semin Roentgenol 28: 109–118CrossRefPubMedGoogle Scholar
  25. 25.
    Moon WK, Im JG, Yeon KM, Han MC (1998) Mediastinal tuberculous lymphadenitis: CT findings of active and inactive disease. AJR Am J Roentgenol 170: 715–718PubMedGoogle Scholar
  26. 26.
    Mukherjee JS, Rich ML, Socci AR et al. (2004) Programs and principles in treatment of multidrug-resistant tuberculosis. Lancet 363: 474–481CrossRefPubMedGoogle Scholar
  27. 27.
    Penner C, Roberts D, Kunimoto D et al. (1995) Tuberculosis as a primary cause of respiratory failure requiring mechanical ventilation. Am J Respir Crit Care Med 151: 867–872PubMedGoogle Scholar
  28. 28.
    Rossi SE, Franquet T, Volpacchio M et al. (2005) Tree-in-bud pattern at thin-section CT of the lungs: radiologic-pathologic overview. Radiographics 25: 789–801PubMedGoogle Scholar
  29. 29.
    Saurborn DP, Fishman JE, Boiselle PM (2002) The imaging spectrum of pulmonary tuberculosis in AIDS. J Thorac Imaging 17: 28–33CrossRefPubMedGoogle Scholar
  30. 30.
    Snider GL (1969) Bronchogenic carcinoma and pulmonary tuberculosis. Dis Chest 55: 181–182PubMedGoogle Scholar
  31. 31.
    Thompson BH, Stanford W, Galvin JR, Kurihara Y (1995) Varied radiologic appearances of pulmonary aspergillosis. Radiographics 15: 1273–1284PubMedGoogle Scholar
  32. 32.
    Ting YM, Church WR, Ravikrishnan KP (1976) Lung carcinoma superimposed on pulmonary tuberculosis. Radiology 119: 307–312PubMedGoogle Scholar
  33. 33.
    Tuengerthal S (2003) Tuberkulose. In: Galanski M (Hrsg) Handbuch diagnostische Radiologie: Thorax. Springer, Berlin Heidelberg New York, S 250–273Google Scholar
  34. 34.
    Winer-Muram HT, Rubin SA (1990) Thoracic complications of tuberculosis. J Thorac Imaging 5: 46–63CrossRefPubMedGoogle Scholar
  35. 35.
    Woodring JH, Vandiviere HM, Fried AM et al. (1986) Update: the radiographic features of pulmonary tuberculosis. AJR Am J Roentgenol 146: 497–506PubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  • E. Eisenhuber
    • 1
    Email author
  • G. Mostbeck
    • 1
  • A. Bankier
    • 2
  • A. Stadler
    • 2
  • R. Rumetshofer
    • 3
  1. 1.Institut für RöntgendiagnostikOtto-Wagner-SpitalWienÖsterreich
  2. 2.Klinik für RadiodiagnostikMedizinische Universität WienWienÖsterreich
  3. 3.Interne LungenabteilungOtto-Wagner-Spital WienWienÖsterreich

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