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Pulmonary Tuberculosis: Up-to-Date Imaging and Management

¹ Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan, Korea.
² Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.

OBJECTIVE. Pulmonary tuberculosis (TB) is a common worldwide infection and a medical and social problem causing high mortality and morbidity, especially in developing countries. The traditional imaging concept of primary and reactivation TB has been recently challenged, and radiologic features depend on the level of host immunity rather than the elapsed time after the infection. We aimed to elaborate the new concept of the diagnosis and treatment of pulmonary TB, to review the characteristic imaging findings of various forms of pulmonary TB, and to assess the role of CT in the diagnosis and management of pulmonary TB.

CONCLUSION. Fast and more accurate TB testing such as bacterial DNA fingerprinting and whole-blood interferon- assay has been developed. Miliary or disseminated primary pattern or atypical manifestations of pulmonary TB are common in patients with impaired immunity. CT plays an important role in the detection of TB in patients in whom the chest radiograph is normal or inconclusive, in the determination of disease activity, in the detection of complication, and in the management of TB by providing a roadmap for surgical treatment planning. PET scans using ¹⁸F-FDG or ¹¹C-choline can sometimes help differentiate tuberculous granuloma from lung malignancy.

Keywords: lung CT • lung disease • lung infection • tuberculosis • pulmonary

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This article has been cited by other articles:

				B. J. Marais, S. K. Parker, S. Verver, A. van Rie, and R. M. Warren Primary and Postprimary or Reactivation Tuberculosis: Time to Revise Confusing Terminology? Am. J. Roentgenol., April 1, 2009; 192(4): W198 - W198. [Full Text] [PDF]

				Y. J. Jeong, W.-J. Koh, and K. S. Lee Reply Am. J. Roentgenol., April 1, 2009; 192(4): W199 - W200. [Full Text] [PDF]