title: Computed tomography features of extensively drug-resistant pulmonary tuberculosis in non-HIV-infected patients.
abstract: OBJECTIVE
  To describe the computed tomography (CT) findings of pulmonary extensively drug-resistant tuberculosis (XDR-TB) in non-HIV-infected patients and to compare them with those of non-XDR multidrug-resistant tuberculosis (MDR-TB).
  
  
  METHODS
  Retrospective review of microbiological results and drug-susceptibility tests of 260 non-HIV-infected patients who had been diagnosed with pulmonary MDR-TB from 1994 to 2005 revealed that 47 patients had XDR-TB, whereas the other 213 patients had non-XDR MDR-TB. Twenty of the 47 XDR-TB patients and 85 of the 213 non-XDR MDR-TB patients with available CT examinations were included in this study. Two radiologists reviewed the CT studies in consensus for the presence and extent of micronodules, tree-in-bud appearance, lobular consolidation (<2 cm), consolidation, cavity, bronchiectasis, emphysema, pleural effusion, lymphadenopathy, bronchopleural fistula, and empyema. We then compared the CT features of XDR-TB with those of non-XDR MDR-TB.
  
  
  RESULTS
  Micronodules and tree-in-bud appearance were the most frequent CT abnormalities and were seen in all XDR-TB patients (100%). Consolidations, cavities, bronchiectasis, and lobular consolidations were found in 85%, 85%, 80%, and 70% of XDR-TB patients, respectively. The extents of micronodules, tree-in-bud appearance, lobular consolidation, consolidation, cavity, bronchiectasis, and emphysema were 3.60, 3.55, 1.35, 1.85, 1.65, 1.45, and 0.25 lobes, respectively. Compared with non-XDR MDR-TB, XDR-TB showed a significantly larger extent of tree-in-bud appearance and consolidation (P < 0.05). With respect to other CT features, there were no significant differences between XDR-TB and non-XDR MDR-TB.
  
  
  CONCLUSIONS
  Computed tomography findings of pulmonary XDR-TB are similar to those of non-XDR MDR-TB; however, XDR-TB tends to have more extensive consolidation and tree-in-bud appearance.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Korea.
authors.forename: Eun Sun
authors.initials: ES
authors.lastname: Lee
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Park
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Goo
authors.forename: Jae-Joon
authors.initials: JJ
authors.lastname: Yim
authors.forename: Hye-Ryoun
authors.initials: HR
authors.lastname: Kim
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: In Sun
authors.initials: IS
authors.lastname: Lee
authors.forename: Jung-Gi
authors.initials: JG
authors.lastname: Im
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001982:Bronchial Diseases / Q000150:complications / Q000000981:diagnostic imaging; D003287:Contrast Media; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D004654:Empyema, Tuberculous / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology; D008206:Lymphatic Diseases / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010996:Pleural Effusion / Q000150:complications / Q000000981:diagnostic imaging; D011656:Pulmonary Emphysema / Q000150:complications / Q000000981:diagnostic imaging; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide