PULMONARY TUBERCULOSIS - RADIOLOGICAL IMAGES -. Dr. Miron Ramona Conf Dr Antigona Trofor. TUBERCULOSIS RADIOLOGY. Pulmonary tuberculosis, especially postprimary disease, nearly always causes abnormalities on chest radiographs.
Dr. Miron Ramona
Conf Dr Antigona Trofor
GOHN focus (alveolitis)=basal subpleural nodular opacities (most often on right), flou contour
Lymphangitis: radiological expression, in some case appear fibrosis; fine linear opacities that connect the Gohn focus with hilum
Homolateral adenopathy: hilary, interbronchial or paratracheal rounded shape, massive polyciclic aspect,
Segmental atelectasis in upper right lobe
- Can do to excavation
Is accompanied by adenopathy
Pneumonie TB lob superior drept
Macronodulare alveolar opacities, various sizes, unequal distribution, with a tendency to confluence
Right paratracheal adenopathy
Can occur after primary infection,
Radiology- polymorphic semiology!
Alveolar opacities systematized/nonsystematized;
Nodular images, cavitary lesions, fibrous lesions, associated lesions
The affected territories predilection: dorsal and apical segments of upper lobes and apical segments of lower lobes!
Beginning of secondary TB can be: pneumonia, lobar or segmental opacities , bronchopneumoni
infiltrative TB RUL
Massive left pneumonia – etiology TB
In a patient with pleural exudate, TB is the first etiology to be taken into consideration!
Cavity grade 1
Cavity grade 2
Cavity grade 3
Cavity grade 1:
Lucency (darkened area) within the lung parenchyma, with or without irregular margins
Cavern with net wall localized RUL subclavicular
Between cavern and hilum- drainage bronchia
Cavity grade 3: old cavity, net shaped, wall fibrosis, cavitary sclerosis may be due to irregular shape, around the cavity disabling injuries. Calcification can exist around a cavity.
Multiple cavities in different stages of evolution
small, multiple aspects in different stages of evolution
(AFTER RESORBTION OF EXUDATE)
(INFECTION OF EXUDATE)
TB infiltrative lesions of RUL
Mixed image horizontal line of the air-fluid level right hemithorax
Pulmonary hiperlucency design collapsed lung to hilum (right lung field), large infiltrative lesions (left lung field)
Micronodular opacities, diffuse shape, vaguely defined, tendency to confluence to delimit small areas excavated
Bronchogenic dissemination from RUL to LIL(disemination type “Cardis”)
Hiperlucency excluding left lung, with attraction of trachea to the left, ascension compensatory of the diaphragm, hyperinflation of contralateral lung, right lung shows extensive infiltrative lesions and a cavity to the apex
Images - multi-drug resistance TB