Learning objectives
To illustrate the characteristic imaging features of Multidrug-resistant tuberculosis (MDR-TB) and Extensively drug-resistant tuberculosis (XDR-TB) compared with non MDR-TB.
In this poster we will review the definitionof MDR-TB and XDR-TB and their epidemiological and clinical significances.
Then we will summarize typical imaging features of typical pulmonary tuberculosis.
After that,
we will show differential imaging characteristics between non MDR-TB and MDR-TB.
We will also present difference between non-XDR MDR-TB and XDR-TB.
Background
Definition of Multidrug-resistant tuberculosis (MDR-TB):
A disease caused by Mycobacterium tuberculosis strains with resistance to at least isoniazid and rifampicin.
Definition of Extensively drug-resistant tuberculosis (XDR-TB):
A disease caused by Mycobacterium tuberculosis strains resistant to fluoroquinolone and at least 1 of 3 injectable second-line drugs (ie,
capreomycin,
kanamycin and amikacin) as well as both isoniazid and rifampicin (Fig.1).
Epidemiology and Clinical Significance of MDR-TB and XDR-TB:
There were an estimated 390 000–510 000 cases of MDR-TB (primary and acquired) arising in 2008,
with the best...
Imaging findings OR Procedure details
Imaging review of pulmonary tuberculosis
Cavity(20-45%): The radiologic hallmark of reactivation TB and begins from the oldest portion of the lesions,
which are centrilobular in location.
Cavity occurs when an area of caseous necrosis liquefies and communicates with the bronchial tree.
The presence of a cavity is an important sign that indicates active disease.
(Fig.1,2)
Bronchogenic spread: The centrilobular small nodules and
tree-in-bud sign(branching linear structure 2 to 4 mm in diameter) reflect the presence of endobronchial spread and are due to the presence of...
Conclusion
MDR-TB and XDR-TB are already distributed worldwide and has worse prognosis compared with drug-sensitive TB.
Imaging features of MDR-TB are basically similar with known imaging feature of drug-sensitive TB,
however there are some differences such as multiple cavities,
extensive lobar involvement of small nodules,
more frequent bronchiectasis.
XDR-TB shows more extensive pulmonary abnormalities such as consolidations and tree-in-bud appearance than MDR-TB,
although XDR-TB shares a lot of common imaging findings with MDR-TB.
Personal Information
Y.
Song,
C.
M.
Park.
Department of Radiology,
Seoul National University Hospital,
28 Yeongon-dong,
Jongno-gu,
Seoul 110-744,
Korea
mail to:
[email protected]
References
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Imaging findings of primary multidrug-resistant tuberculosis: a comparison with findings of drug-sensitive tuberculosis.
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Radiological findings of extensively drug-resistant pulmonary tuberculosis in non-AIDS adults: comparisons with findings of multidrug-resistant and drug-sensitive tuberculosis.
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Jeong,
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and K.S.
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Pulmonary tuberculosis: up-to-date...