CT and MRI in the diagnosis of tuberculosis

Bharati

Indian J Radiol Imaging

2013

This article reviews the computed tomography and magnetic resonance imaging (MRI) features of renal tuberculosis (TB), including TB in transplant recipients and immunocompromised patients. Multi detector computed tomography (MDCT) forms the mainstay of cross-sectional imaging in renal TB. It can easily identify calcification, renal scars, mass lesions, and urothelial thickening. The combination of uneven caliectasis, with urothelial thickening and lack of pelvic dilatation, can also be demonstrated on MDCT. MRI is a sensitive modality for demonstration of features of renal TB, including tissue edema, asymmetric perinephric fat stranding, and thickening of Gerota's fascia, all of which may be clues to focal pyelonephritis of tuberculous origin. Diffusion-weighted MR imaging with apparent diffusion coefficient (ADC) values may help in differentiating hydronephrosis from pyonephrosis. ADC values also have the potential to serve as a sensitive non-invasive biomarker of renal fibrosis. Immunocompromised patients are at increased risk of renal TB. In transplant patients, renal TB, including tuberculous interstitial nephritis, is an important cause of graft dysfunction. Renal TB in patients with HIV more often shows greater parenchymal affection, with poorly formed granulomas and relatively less frequent findings of caseation and stenosis. Atypical mycobacterial infections are also more common in immunocompromised patients.

“…Inflammatory granulomatous and caseating masses show enhancement. [26] Focal or diffuse cortical scarring and non-function are other findings of advanced disease. [27]…”

Section: Computed Tomographymentioning

confidence: 99%

Section: Computed Tomographymentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part II

Bharati

Indian J Radiol Imaging

2013

“…Focal, segmental, and polar involvement can be demonstrated. Inflammatory granulomatous and caseating masses show enhancement [21].…”

Section: Computed Tomographymentioning

confidence: 99%

Multidetector CT in Renal Tuberculosis

Sankhe

Joshi

2014

Curr Radiol Rep

Tuberculosis (TB) is one of the commonest infectious diseases in the developing countries with rising incidence seen due to HIV and AIDS. Pulmonary tuberculosis is the commonest form seen. Renal Tuberculosis is the most common extrapulmonary form. There are no specific clinical symptoms associated with renal tuberculosis. The constitutional symptoms like low grade fever, weight loss, anorexia commonly seen with pulmonary TB are not usually seen with renal TB. Renal TB is also cause of interstitial nephritis which leads to end-stage renal failure. Hence the role of radiologist assumes importance in supporting the timely diagnosis although cultures or histologic analysis is required for definitive diagnosis. The individual imaging finding may not be diagnostic as it can be seen with other renal pathologies too, however, presence of multiple imaging findings in a single case is pointer to this disease. Renal TB involves both cortex and collecting system. This article gives review of pathophysiology and computed tomography features of Renal TB.

“…If calcification is present, it is more suggestive of tuberculosis. [6] CT is also an excellent substitute for retrograde pyelogram, because in many situations due to an inflamed or contracted bladder, the ureteric orifice could not be identified. Additionally, presence of a golf hole ureter in itself is not suggestive of vesico-ureteric reflux, as in TB, golf hole orifice can be seen concomitantly with obstruction.…”

Section: Role Of Imagingmentioning

confidence: 99%

Surgical management of renal tuberculosis

Krishnamoorthy¹,

Gopalakrishnan²

2008

Indian J Urol

Tuberculosis (TB) is one of the major health problems that our country is facing today. Despite active interventions by our government, control of TB still remains to be achieved. The emergence and exponential growth of the human immunodeficiency virus and drug-resistant strains threaten to further complicate the TB situation in our country. Even in this era of advanced chemotherapy, many lives are lost every day in our country. Tuberculosis of the urinary tract, despite being one of the commonest forms of extra-pulmonary TB, is generally overlooked. Most patients present with vague lower urinary symptoms typical of urinary tract infection. In this article, we shall highlight the various issues related to the surgical management of renal and ureteral tuberculosis.