[Disseminated pulmonary tuberculosis: significance of high-resolution computerized tomography]. / Disseminirovannyi tuberkulez legkikh: znachenie vysokorazteshiushchei KT.

Clinical and X-Ray studies were performed in 85 patients with disseminated pulmonary tuberculosis. All the patients underwent routine computerized tomography (CT) and high-resolution CT. According to the pathogenetic process, the authors identified hematogenic (n = 38), lymphogenic (n = 19), bronchogenic (n = 18) and mixed (n = 10) disseminations. High-resolution CT was found to have great advantages in detecting various types of tuberculous disseminations and in assessing the pattern of pulmonary abnormalities. Disseminated tuberculosis was revealed in 7 patients who had no pathological changes on routine lung X-ray films. The specific signs of hematogenic, lymphogenic disseminations and bronchgenic inoculations were identified in other forms of pulmonary tuberculosis. CT symptomatology is shown to be determined by the pathogenetic variant of its development and the stage of the process. Small focal changes in the lung were prevalent in patients with acute and subacute hematogenic forms of the disease. Infiltrates with decay cavities, thin-wall caverns, emphysema and bronchoectases were detected over the chronic course. Lymphogenic disseminations were characterized by the predominance of interstitial changes along with multiple minor foci. High-resolution CT had advantages in identifying decay cavities, signs of fibrosis and in evaluating mediastinal lymph nodes. CT data are of great significance for differential diagnosis of disseminated tuberculosis with lung metastases and diffuse interstitial diseases.

[Computed tomography in the diagnosis of infiltrative pulmonary tuberculosis]. / Kompíuternaia tomografiia pri infiltrativnom tuberkulëze lëgkikh.

Computer-aided tomography (CAT) was carried out in 67 patients with infiltrative pulmonary tuberculosis. Both standard and high-resolution CAT were used to assess the lung status. The data were correlated to x-ray findings. Advantages of high-resolution CAT in the detection of destruction cavities, foci and interstitial changes were shown. CAT helps differentiate between the changes in the tuberculous infiltrate due to pulmonary tissue caseous necrosis and the perifocal reactions presenting as local edema and serous inflammation. CAT is the most effective in the differential diagnosis of pulmonary infiltration of unknown origin, in specification of the tuberculous process phase, in assessment of the type of residual changes, and in planning of surgery.