Imaging of Tuberculosis

Lundstedt, C.; Nyman, Rickard; Brismar, J.; Hugosson, Claes; Kagevi, I

doi:10.1177/02841851960373p213

Cited by 48 publications

(4 citation statements)

References 35 publications

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“…As both CD and ITB are transmural diseases, mural stratification can be seen in both and should not be considered as a differentiating marker between the two diseases. Classically isolated ileocecal involvement has been labeled as a diagnostic hallmark of ITB 3738. However, in the present review, ileocecal involvement had a relatively poor specificity (77%) in differentiating CD and ITB.…”

Section: Discussionmentioning

confidence: 50%

Accuracy of computed tomographic features in differentiating intestinal tuberculosis from Crohn's disease: a systematic review with meta-analysis

et al. 2017

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Abdominal computed tomography (CT) can noninvasively image the entire gastrointestinal tract and assess extraintestinal features that are important in differentiating Crohn's disease (CD) and intestinal tuberculosis (ITB). The present meta-analysis pooled the results of all studies on the role of CT abdomen in differentiating between CD and ITB. We searched PubMed and Embase for all publications in English that analyzed the features differentiating between CD and ITB on abdominal CT. The features included comb sign, necrotic lymph nodes, asymmetric bowel wall thickening, skip lesions, fibrofatty proliferation, mural stratification, ileocaecal area, long segment, and left colonic involvements. Sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio (DOR) were calculated for all the features. Symmetric receiver operating characteristic curve was plotted for features present in >3 studies. Heterogeneity and publication bias was assessed and sensitivity analysis was performed by excluding studies that compared features on conventional abdominal CT instead of CT enterography (CTE). We included 6 studies (4 CTE, 1 conventional abdominal CT, and 1 CTE+conventional abdominal CT) involving 417 and 195 patients with CD and ITB, respectively. Necrotic lymph nodes had the highest diagnostic accuracy (sensitivity, 23%; specificity, 100%; DOR, 30.2) for ITB diagnosis, and comb sign (sensitivity, 82%; specificity, 81%; DOR, 21.5) followed by skip lesions (sensitivity, 86%; specificity, 74%; DOR, 16.5) had the highest diagnostic accuracy for CD diagnosis. On sensitivity analysis, the diagnostic accuracy of other features excluding asymmetric bowel wall thickening remained similar. Necrotic lymph nodes and comb sign on abdominal CT had the best diagnostic accuracy in differentiating CD and ITB.

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Section: Discussionmentioning

confidence: 50%

Accuracy of computed tomographic features in differentiating intestinal tuberculosis from Crohn's disease: a systematic review with meta-analysis

et al. 2017

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“…Prior studies also reported the ileocecum as the most commonly affected site of ITB [ 6 , 11 , 23 , 24 ]. The abundance of lymphoid tissues, the relatively longer time for fecal stasis, the appropriate neutral pH environment and the absorptive transport mechanisms (increasing rate of fluid and electrolyte absorption) of the ileocecum work together to allow the swallowed mycobacterium to be absorbed and might contribute to the predilection of ITB [ 25 ].…”

Section: Discussionmentioning

confidence: 98%

Evaluation of intestinal tuberculosis by multi-slice computed tomography enterography

et al. 2015

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BackgroundMulti-slice computed tomography enterography (MSCTE) is now widely used to diagnose and monitor intestinal disease. Preliminary studies suggest that MSCTE may be useful in detecting intestinal tuberculosis (ITB). We sought to assess the use of MSCTE for the diagnosis of ITB in our medical center.MethodsIn this retrospective study, 15 patients (11 males and 4 females, 6 to 65 years old) were enrolled and diagnosed with ITB by MSCTE. Diagnosis were confirmed by pathology or clinical criteria. Two experienced abdominal radiologists evaluated the images and defined the location, number, shape, edge, surrounding tissue alterations of ITB and other associated changes in the peritoneum, mesentery and solid abdominal organs.ResultsThe interval between the onset of symptoms and diagnosis varied from 20 days to 10 years. The most common symptom was abdominal pain (80 %). The ileocecum was the most common site affected by ITB (87 %). Morphological MSCTE findings were variable and included multi-segmental symmetric intestinal mural thickening found in 6 patients (40 %), solid masses found in 9 patients (60 %), and enlarged lymph nodes (LNs) found in 13 (87 %) patients. Non-enhancing central necrosis and rim enhancement were noted in 10 patients (67 %).ConclusionsCharacteristic MSCTE findings of ITB include solid mass or multi-segmental symmetric mural thickening involving the ileocecal area and rim enhanced LNs. Knowledge of these features in combination with a high index of suspicion can be useful in early diagnosis of ITB.

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“…Clinical, radiological, endoscopic, and histological features are helpful in differentiating ITB from CD. [ 55 56 57 ] These differences are presented in Table 4 .…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Intestinal tuberculosis versus crohn's disease: Clinical and radiological recommendations

Sharma

Madhusudhan

Ahuja

2016

Indian Journal of Radiology and Imaging

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Intestinal tuberculosis is a common clinical problem in India. The clinical features of this disease are nonspecific and can be very similar to Crohn's disease. Radiological evaluation of the small bowel has undergone a paradigm shift in the last decade. This long tubular organ that has traditionally been difficult to evaluate can now be well-visualized by some innovative imaging and endoscopic techniques. This article highlights the state-of-the-art evaluation of ulceroconstrictive diseases of the bowel and provides recommendations for the differentiation of intestinal tuberculosis from Crohn's disease.

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Imaging of Tuberculosis

Abstract: The need to consider TB in the differential diagnosis in patients with obscure abdominal symptoms, especially with multiple organ involvement, is stressed.

Cited by 48 publications

References 35 publications

Accuracy of computed tomographic features in differentiating intestinal tuberculosis from Crohn's disease: a systematic review with meta-analysis

Accuracy of computed tomographic features in differentiating intestinal tuberculosis from Crohn's disease: a systematic review with meta-analysis

Evaluation of intestinal tuberculosis by multi-slice computed tomography enterography

Intestinal tuberculosis versus crohn's disease: Clinical and radiological recommendations

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