Tuberculosis CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

The majority of patients with pulmonary tuberculosis will have abnormal findings in a chest CT, which include micronodules, interlobular septal thickening, cavitation and consolidation.

Computed Tomography

Pulmonary Tuberculosis

  • Chest CT abnormalities are seen in the majority of patients with active pulmonary tuberculosis.
  • CT finding include:[1]
  • Micronodules
  • Interlobular septal thickening
  • Cavitation
  • Consolidation.
  • Micronodules are most commonly located in the subpleural region and peribronchovascular interstitium.

Extrapulmonary Tuberculosis

Cardiac Tuberculosis

  • Pericardial thickening may be seen in a CT, specially if it is more than 3 mm.[2]
  • Lymph node enlargment is also a common CT findings in cardiac tuberculosis.[2]
  • Pericardial effusion is seen in less than 20% of patients.[2]

Disseminated Tuberculosis

Tuberculous Meningitis

  • Head CT findings in tuberculous meningitis include meningeal enhancement consistent with meningeal inflammation and coroidal calcifications.[3]
  • Areas of infarction and hemorrhage may also be seen in cases of miliar tuberculosis.
  • Patients with late complications may show hydrocephalus.
Image courtesy of Wikimedia Commons.


Abdominal Tuberculosis

  • CT findings in a pancreatic and spleen infection with tuberculosis may mimic a pancreatic cancer.[4]
  • Shown below there is CT scan of the pancreas demonstrating a mass in the pancreatic tail and metastasizes in the spleen.
Image courtesy of Wikimedia Commons.
Image courtesy of Wikimedia Commons.

References

  1. Jeong Min Ko, Hyun Jin Park & Chi Hong Kim (2014). "Pulmonary Changes of Pleural Tuberculosis: Up-to-Date CT Imaging". Chest. doi:10.1378/chest.14-0196. PMID 25086249. Unknown parameter |month= ignored (help)
  2. 2.0 2.1 2.2 Burrill, Joshua; Williams, Christopher J.; Bain, Gillian; Conder, Gabriel; Hine, Andrew L.; Misra, Rakesh R. (2007). "Tuberculosis: A Radiologic Review1". RadioGraphics. 27 (5): 1255–1273. doi:10.1148/rg.275065176. ISSN 0271-5333.
  3. Komolafe, Morenikeji A; Sunmonu, Taofiki A; Esan, Olufunmi A (2008). "Tuberculous meningitis presenting with unusual clinical features in Nigerians: Two case reports". Cases Journal. 1 (1): 180. doi:10.1186/1757-1626-1-180. ISSN 1757-1626.
  4. Rong, YF; Lou, WH; Jin, DY (2008). "Pancreatic tuberculosis with splenic tuberculosis mimicking advanced pancreatic cancer with splenic metastasizes: a case report". Cases Journal. 1 (1): 84. doi:10.1186/1757-1626-1-84. ISSN 1757-1626.

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