CT Manifestations of Acquired Immunodeifciency Syndrome Combined with Pulmonary Tuberculosis and Pulmonary Tuberculosis / 中国医学影像学杂志

ABSTRACT

PurposePulmonary tuberculosis (PTB) in the patients with AIDS often manifest as an atypical clinical manifestations, less positive rate in lab and various imaging features. This paper aims to compare the clinical and imaging manifestations of PTB in patients with AIDS and in patients with normal immunity may help us to improve the understanding of PTB in AIDS.Materials and MethodsThe clinical manifestations, the lab results and chest imaging data of 142 conifrmed PTB in patients with AIDS (observation group) and 150 conifrmed PTB in patients with normal immunity (control group) were retrospectively analyzed, the imaging review included the site, shape, density, property and the enhancement patterns of the enlarged lymph node in mediastinum and the status of pleura.ResultsThe incidences of fever, dyspnea, asthenia, anorexia, loss of weight, diarrhea, blurred vision, urinary irritation, oral leukoplakia, pruritus, rash, other pulmonary infections and extrapulmonary tuberculosis in observation group were signiifcantly higher than those in control group (χ2=4.173-68.542,P<0.05,P<0.01,P<0.001). The positive rates of tuberculosis in cough, hemoptysis, putum smear and sputum culture in observation group were signiifcantly lower than those in control group (χ2=30.376, 9.254 and 16.200, P<0.05). Imaging manifestations: observation group of type I, type II, type IV and type V patients were more than those in the control group (χ2=5.977, 8.621, 18.769 and 20.864, P<0.05). The lesions located at middle and lower lobes and involved more than three lobes in observation group than in control group at the same time (χ2=18.692 and 5.860,P<0.05, P<0.001), military nodules, enlarged lymph nodes in mediastinum and pleural effusion appeared more commonly in observation group than in control group (χ2=13.404, 34.704 and 19.469,P<0.001), while calcification, fibrosis and cavity were less in observation group compared to control group (χ2=6.539, 4.658 and 7.280,P<0.05,P<0.01,P<0.001). ConclusionPTB should be considered when AIDS patients present multiple symptoms in whole body, with pulmonary lesions located at middle and lower lobes & involved more than three lobes, military nodules, mediastinal enlarged lymph nodes and pleural effusion.