Radiologic semiotics of destructive tuberculosis and nontuberculous pulmonary mycobacteriosis

The aim of the study was to investigate computed tomographic signs of destructive forms of tuberculosis and nontuberculous mycobacterioses of the lungs. Materials and methods. Сomputed tomography data were analyzed in 154 patients with destructive forms of tuberculosis (78 patients) and nontuberculous mycobacterioses of the lungs (76 patients); the diagnosis was confirmed by isolation of Mycobacterium tuberculosis or various nontuberculous mycobacteria identified by microbiological methods to species in the diagnostic material. Results . Тhe CT picture in tuberculosis was more characterized by irregular-round shape of caverns (57.8%), vagueness of their external contour, multiple destructions (47.4%), infiltration of the adjacent pleura (83.3%); the thickness of the cavity wall and pericavitary infiltration more often exceeded 1 cm. In non-tuberculous mycobacteriosis, solitary cavities of irregular-oval shape, with thin walls (less than 5 mm) with calcinosis (40,8%), clear external contour (82,9%), open bronchocavitary joints (in 81,6% of cases) were more often detected; bronchiectasis (92,1%), hyperinflation and fibrosis, foci of bronchogenic dissemination were more frequent in the surrounding lung tissue. Conclusion. Сareful analysis of CT semiotics of destructive forms of tuberculosis and pulmonary mycobacteriosis contributes to the efficiency of differential diagnosis and routing of patients with these diseases.