Expert consensus on imaging diagnostic criteria for pulmonary tuberculosis associated with acquired immunodeficiency syndrome

Abstract

Acquired immunodeficiency syndrome (AIDS)-associated pulmonary tuberculosis is one of the most common opportunistic infections in patients with AIDS and an important cause of death. Pulmonary tuberculosis associated with AIDS occurs in patients with low immunity, and its clinical manifestations are often atypical. Therefore, diagnosis of AIDS-associated pulmonary tuberculosis is difficult, and imaging plays a vital role. To standardize examinations and improve the level of imaging diagnosis, a group of experts in infection, inflammation, radiology, tuberculosis, and statistics have come together and published imaging diagnostic criteria for AIDS-related pulmonary tuberculosis with consideration of the methodological requirements for evidence-based guidelines and standards. Patients with clinical signs and symptoms of pulmonary infection who test positive for human immunodeficiency virus need to undergo further radiographic or computed tomography examination of the chest. AIDS-related pulmonary tuberculosis is suspected when there are pulmonary lesions and/or hilar and mediastinal lymph node enlargement. An imaging diagnosis of AIDS-related pulmonary tuberculosis is based on one of the following findings: mediastinal or hilar lymphadenectasis in multiple areas, diffuse miliary nodules randomly distributed in both lungs, multi-form, multi-lobular, and multi-segmental lesions dominated by exudative lesions, or pleural effusion. Further laboratory or pathological examinations are performed in suspected patients and those with an imaging diagnosis; if one of these additional examinations is positive, the diagnosis of AIDS-related tuberculosis is confirmed.