Radiological characterization of disseminated tuberculosis in patients with AIDS

ObjectiveThis study aimed to analyze and characterize the radiological manifestations of disseminated tuberculosis in patients with AIDS and to improve its diagnostic accuracy.Materials and methodsThe radiological images of disseminated tuberculosis in 40 patients with AIDS were retrospectively analyzed with special focus on the distribution, location and enhancement pattern of the lesions.ResultsThe lesions were shown with involvement of lungs (87.5%), lymph nodes (72.5%), spleen (27.5%), liver (12.5%), CNS (7.5%), pleura (15%), ileocecal junction (7.5%), soft tissues (7.5%), peritoneum (7.5%), kidney (5%), and bone (5%). CT manifestations were characterized by military nodules at lungs (27.5%), spleen (22.5%), liver (7.5%); focal lesions with rim enhancement in the CNS (12.5%), soft tissues (7.5%), spleen (5%), and liver (5%); intrathoracic lymphadenopathy with rim enhancement (62.5%) and those in abdomen (68.8%). Intrathoracic lymphadenopathy dominantly distributed in 4R (79.3%), 7 (72.4%), and 2R (58.6%), while abdominal lymphadenopathy dominantly distributed in the portacaval space (87.5%), peripancreatic region (87.5%), and hepatoduodenal ligament (81.3%).ConclusionsDisseminated tuberculosis in patients with AIDS affects multiple sites, and the most commonly affected region is lungs, followed by lymph nodes, spleen and liver, CNS, and others. The radiological features include miliary pattern in lung, spleen, and liver, with dominant distribution of lymphadenopathy and rim enhancement. The focal lesions with rim enhancement at multiple sites highly suggest the diagnosis of disseminated tuberculosis in patients with AIDS.