High-resolution CT (HRCT) reconstructions are especially useful to detect miliary and centrilobular nodules, ground-glass opacities, and air-trapping. Contrast-enhanced CT (CECT) is the investigation of choice for evaluation of mediastinal LNs and also aids in depicting pleural enhancement in empyema. CT enables evaluation of bronchiectasis, cavitation, associated fungal balls, and assessment of necrosis in the LNs, identifying pleural/airway/diaphragmatic pathologies and evaluating visualized bones. It not only enables earlier and more accurate diagnosis of pulmonary lesions, but also can be used to differentiate the etiologies of pneumonia. For optimal management, the radiologists are often expected to deliver important information, while limiting the radiation exposure and costs to the patients.ĬT chest - Multi-detector CT (MDCT) is an important tool in the detection of radiographically occult disease, differential diagnosis of parenchymal lesions, evaluation of mediastinal lymph nodes (LNs), assessing disease activity, and evaluating complications. Because of these limitations, imaging plays an important role in evaluation of chest TB (CTB) patients and CT is more sensitive than CXR in this regard. These tests also suffer from low sensitivity. This limits the diagnostic efficiency of these conventional approaches and frequently causes delays in isolating infectious patients. Sputum smear results take several days while culture results need several weeks. With India having a large burden of TB, it is important to have established imaging criteria and recommendations. Literature is lacking and no consensus exists on use of ultrasound (USG), CT, and magnetic resonance imaging (MRI) in such patients. Though computed tomography (CT) is frequently employed in the diagnosis and follow-up of TB, it does not find a place in the national and international guidelines. Chest radiograph (CXR) finds its place in sputum-negative patients not responding to a course of antibiotics. The current guidelines for diagnosis of adult chest tuberculosis (TB) are based primarily on the demonstration of acid-fast bacilli (AFB) on sputum microscopy.
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