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The Radiology of Tuberculosis
Ronald J. Karpick, M.D.
Fairfax County Health Department
9/15/09
New England TB Intensive
Today’s Objectives
• Learn how Radiation is produced and how
much an individual receives during a CXR
• Learn the major landmarks of the CXR
• Learn to distinguish Primary and Post
primary Pulmonary TB on the CXR
• Review the appearance of TB infection in
other organ systems
Primary Tuberculosis
• First infection with M. tuberculosis
• Most commonly by way of inhaled air
• Primary or Ghon focus
• Lymphatic spread
• Hematogenous spread
• Development of Delayed Hypersensitivity and Cell Mediated Immunity within 8 weeks
Post-Primary or Reactivation TB
• Reactivation of a previously dormant primary infection, though in a small number of cases, it is the extension of the primary infection if it occurs within a year of the initial infection.
• It is a disease of adolescents and adults
• It affects primarily the upper lobes with a propensity to cavitate,
• Extra pulmonary sites include the LN, Pleura, bone, CNS, GU, Peritoneum
Respiratory
bronchiole
Alveolar duct
Eisenhuber, Radiology 2002;222:771-72
Tree-in-Bud
Today’s Objectives
• Learned how Radiation is produced and how much an individual receives during a CXR
• Learned the major landmarks of the CXR
• Learned to distinguish Primary and Post primary Pulmonary TB on the CXR
• Reviewed the appearance of TB infection in other organ systems
References
• Radiographic Manifestations of Tuberculosis, 2nd
Ed., Daley et al., 2006, Francis J. Curry National Tuberculosis Center
• Diagnosis of Diseases of the Chest, Fraser & Pare’ WB Saunders, 1970
• Tuberculosis from Head to Toe, Harisinghani et al., RadioGraphics 2000; 20: 449-470
• Introduction to Chest Radiology; SB Gay et al., UVA Health Science Center, Department of Radiology, 2003
www.med-ed.virginia.edu/courses/rad/
References
• Atlas Radiologic Anatomy; L.Wicke, 7th English
Edition, Icon Learning Systems, 2004
• Blueprints Radiology; A. Uzelac and RW Davis,
Lippincott Williams & Wilkins, 2006
• Introduction to Diagnostic Imaging; G. Stimac,
WB Saunders 1992
• Getting Started in Clinical Radiology; G. Eastman,
Wald and Crossin, Thieme, 2006