Tuberculosis radiology

Radiological aspects of tuberculosis

Tuberculosis Radiology
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Tuberculosis radiology involves the use of imaging techniques to diagnose and monitor the progression of tuberculosis (TB), a potentially serious infectious disease that primarily affects the lungs. Radiological imaging is a crucial tool in the detection and management of TB, providing visual evidence of the disease's impact on the body.

Radiological Techniques

Chest X-ray

Chest X-ray showing tuberculosis

The chest X-ray is the most common radiological method used to evaluate pulmonary tuberculosis. It can reveal various patterns indicative of TB, such as:

• Infiltrates: These are areas of increased opacity in the lung fields, often seen in the upper lobes.
• Cavitation: The formation of cavities within the lung tissue, which is a hallmark of post-primary TB.
• Pleural effusion: Accumulation of fluid in the pleural space, which can occur in TB.

Computed Tomography (CT)

CT scans provide more detailed images than X-rays and can be used to assess the extent of disease, especially in complex cases. CT is particularly useful for detecting:

• Miliary TB: Characterized by numerous small nodules throughout the lungs.
• Lymphadenopathy: Enlargement of lymph nodes, which can be seen in primary TB.

Magnetic Resonance Imaging (MRI)

While not commonly used for pulmonary TB, MRI can be useful in evaluating TB of the spine (Pott's disease) or the central nervous system.

Radiological Findings in Tuberculosis

Primary Tuberculosis

In primary TB, the initial infection may show a Ghon complex, which consists of a calcified focus of infection and associated lymphadenopathy.

Post-primary (Reactivation) Tuberculosis

Chest X-ray showing reticulonodular densities in post-primary TB

Post-primary TB, also known as reactivation TB, typically affects the upper lobes and is characterized by:

• Cavitary lesions: These are areas of necrosis that appear as hollow spaces within the lung tissue.
• Fibrosis and scarring: Resulting from the healing process, these can lead to volume loss in affected lung areas.

Miliary Tuberculosis

Miliary TB is a form of disseminated TB that occurs when a large number of bacteria spread through the bloodstream. Radiologically, it is identified by:

• Miliary nodules: Numerous small, uniform nodules scattered throughout the lungs.

Role of Radiology in TB Management

Radiology plays a vital role in the diagnosis, monitoring, and follow-up of TB treatment. It helps in:

• Initial diagnosis: Identifying characteristic patterns of TB on imaging.
• Assessing treatment response: Monitoring changes in radiological findings to evaluate the effectiveness of therapy.
• Detecting complications: Identifying complications such as pneumothorax or bronchiectasis.

Also see

• Tuberculosis
• Pulmonary tuberculosis
• Radiology
• Infectious disease