tuberculoza pulmonara-aspecte radiologice
DESCRIPTION
Tuberculoza Pulmonara-Aspecte Radiologice medicinaTRANSCRIPT
![Page 1: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/1.jpg)
TUBERCULOZA PULMONARA
- ASPECTE RADIOLOGICE -
Dr. Miron Ramona
Conf Dr Antigona Trofor
![Page 2: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/2.jpg)
• Boala infectioasa, cronica agentul etiologic: Mycobacterium tuberculosis
• Poate afecta orice organ dar are predilectie pentru plamani
![Page 3: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/3.jpg)
Rolul examenului radiologic:• Diagnostic prezumptiv• In urmarirea evolutiei unei
TB pulmonare confirmate• Imaginea rx a leziunilor TB
nu este specifica DAR modul de evolutie, anumite localizari, unele imagini particulare pot fi sugestive
• Leziunea tuberculoasa
Complexa: include modificari
EXUDATIVE PROLIFERATIVE
FIBROASE
• In interpretarea Rx toracice a unui pacient suspect de TB se vor lua in seama mai multe aspecte:
• Istoricul medical• Examen clinic
• Examen bacteriologic direct si cultura
• I.D.R. la tuberculina
DIAGNOSTICUL = CONFIRMAT
EVIDENTIEREA BACILULUI KOCH!
![Page 4: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/4.jpg)
Primo-infectia
• Leziunile initiale radiologice
COMPLEXUL GOHN-RANKE • Afectul primar = Focar GOHN• Focar Gohn• Limfangita Complex Ranke• Adenopatie
• Imagine “in haltera”
![Page 5: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/5.jpg)
Afect
Limfangita
Adenita
Complexul Ranke
![Page 6: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/6.jpg)
Complexul primar Ranke:1. Sancrul de inoculare
(alveolita) opacitate nodulara bazal subpleural (pe dreapta cel mai frecvent), contur flu.
2. Limfangita: are expresie Rx, in cazul in care se fibrozeaza; opacitati liniare fine hilipede, ce leaga afectul primar de hil.
3. Adenopatie homolaterala: hilara, interbronsica sau latero-traheala de forma rotunjita, cu aspect policiclic rara voluminoasa cu aspect pseudotumoral.
Exista situatii de TB Exista situatii de TB primara progresiva cu primara progresiva cu
aparitia unor forme aparitia unor forme complexe si complexe si complicate!complicate!
1
2
3
![Page 7: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/7.jpg)
Forme complexe• Excavarea focarului de
alveolita cazeoasa – caverna primara: transparenta circumscrisa cu perete fin sau anfractuos; de obicei cu localizare bazala sau in campurile pulmonare mijlocii; se insoteste de adenopatie hilara.
• Adenopatii voluminoase: determina tulburari de ventilatie prin compresie extrabronsica emfizem ostructiv sau atelectazii sistematizate
![Page 8: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/8.jpg)
Adenopatie hilara dreapta Adenopatie hilara dreapta voluminoasa si atelectazie voluminoasa si atelectazie segmentara lob superior segmentara lob superior
dreptdrept
![Page 9: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/9.jpg)
• Fistulizare ganglionara
- fistula ganglio-bronsica
- caverna ganglionara
• Interesarea pleurei
Epansament pleural
(in general redus)
Forme complexe
![Page 10: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/10.jpg)
Forme complicateTuberculoza cazeoasa extinsa cu forma:
A.A. Pneumonica:Pneumonica: extindere de la focarul de alveolita la un segment de ventilatie
opacitate triunghiulara (coresp. unui segm. de ventilatie sau unui lob intreg);
Se poate EXCAVA!
Se insoteste de adenopatii!
Pneumonie TB lob superior
drept
![Page 11: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/11.jpg)
B. Bronhopneumonica: apare prin fistulizarea ganglionilor in bronsie
Opacitati alveolare macronodulare, dimensiuni diferite, distributie inegala, cu tendinta la confluare realizand astfel focare segmentare
Se insoteste de adenopatii!
Adenopatie paratraheala
dreapta Noduli miliari
![Page 12: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/12.jpg)
![Page 13: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/13.jpg)
C. Tuberculoza miliara- Complicatie a TB la copil- La baza- angeita TB –
diseminare limfatica + hematogena
- Radiologic: opacitati miliare cu diametrul < 3 mm, cu dimensiuni egale, distributie omogena
![Page 14: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/14.jpg)
D. Granulia
- Forma generalizata de tuberculoza cu diseminare in mai multe organe determinand:
• MENINGITAMENINGITA• PERICARDITAPERICARDITA
• ATINGERI URO-GENITALE etcATINGERI URO-GENITALE etc. .
![Page 15: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/15.jpg)
Tuberculoza secundara
• Apare ca urmare a reactivarii tuberculozei primare;• Reactivarea leziunilor minime fibrotice din teritoriul apico-
subapical;• Reinfectie prin contaminare exogena;• Poate apare imediat dupa infectia primara;• Semiologia radiologica = polimorfa!polimorfa!
Radiologic:- Opacitati alveolare cu caracter sistematizat sau
nesistematizat;- Imagini nodulare, cavitare, leziuni fibroase, leziuni asociate;
Teritoriile afectate cu predilectie:
Segmentele dorsale si apicale ale lobilor superiori si Segmentele dorsale si apicale ale lobilor superiori si segmentele apicale ale lobilor inferiori ! segmentele apicale ale lobilor inferiori !
![Page 16: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/16.jpg)
1. TUBERCULOZELE INFILTRATIVE
2. PLEUREZIILE SEROFIBRINOASE TUBERCULOASE
3. TUBERCULOZA CAVITARA CRONICA
4. TUBERCULOZA MILIARA
5. TUBERCULOZELE FIBROASE6. TUBERCULOMUL
![Page 17: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/17.jpg)
1. Tuberculozele infiltrative
- Sunt leziuni de alveolita exudativa- Anatomo-patologic: focare de aveolita cazeoasa
inconjurate de congestie perifocala- Infiltratele precoce se localizeaza subclavicular
RADIOLOGIC:
INFILTRATE NODULAREINFILTRATE NODULARE
NFILTRATE ROTUNDE (ASSMAN)NFILTRATE ROTUNDE (ASSMAN)
INFILTRATE NEBULOASEINFILTRATE NEBULOASE
INFILTRATE SEGMENTAREINFILTRATE SEGMENTARE
Debutul tuberculozei secundare poate fi de tip Debutul tuberculozei secundare poate fi de tip pneumonic: opacitati segmentare, lobare, pneumonic: opacitati segmentare, lobare,
bronhopneumonice.bronhopneumonice.
![Page 18: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/18.jpg)
![Page 19: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/19.jpg)
Infiltrate nodulare LSS
TB infiltrativa LSD
![Page 20: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/20.jpg)
Leziuni infiltrative bilateral
![Page 21: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/21.jpg)
Opacitati nodulare diseminate in ambele campuri pulmonare, mai frecvent in campurile pulmonare mijlocii si bazale, intensitate medie, dimensiuni diferite, contur sters, tendinta la confluare
Bronhopneumonie TB
![Page 22: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/22.jpg)
Opaciate triunghiulara localizata la nivelul LSD
Pneumonie TB
![Page 23: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/23.jpg)
Pneumoniile TB – radiologic:• Sindrom de umplere alveolara
cu distributie lobara sau segmentara
• Bronhograma aerica prezenta• Localizare: lobi superiori• Mai frecvent: pe dreapta• Tendinta la excavare centrala• Modificarile rx au dinamica
lenta• Caracterul retractil al
pneumoniei TB este adesea precoce si cu prognostic functional nefavorabil
Evolutia leziunilor infiltrative:
Resorbtie integrala
Organizare fibroasa
Cazeificare cu aparitia zonelor de excavare
si tendinta la extensie
![Page 24: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/24.jpg)
Infiltrat segmentar care ocupa aproape in intregime LSD si cu tendinta la excavare centrala
Pneumonie extinsa stanga de etiologie TB
![Page 25: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/25.jpg)
Opacitate de tip pneumonic, neomogena localizata la nivelul LSD
Pneumonie LSS
![Page 26: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/26.jpg)
2. Pleureziile serofibrinoase tuberculoase
Apar in urmatoarele conditii:- Complicatie a TB primare sau a unei TB secundare;- Expresie a unei diseminari postprimare- Se asociaza cu leziuni parenchimatoase- Lichidul pleural = EXUDAT CU PRED. LIMFOCITARA- Examenul direct, cultura din lichidul pleural, rar sunt
pozitive- Biopsie pleurala: leziuni granulomatoase cu cazeificare- Cultura BK din fragmentele bioptice = frecvent pozitiva
![Page 27: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/27.jpg)
Pleurezie tuberculoasa
La un pacient cu exudat pleural, TB este prima cauza etiologica care
trebuie luata in consideratie !
![Page 28: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/28.jpg)
• Este forma cea mai frecventa = necroza cazeoasa, formare de caverne
• Este rezultatul nefavorabil al evolutiei unei TB incipiente• RADIOLOGIC: opacitati de toate tipurile unice sau multiple
(mici+multiple=aspect de “miez in paine”), leziuni cavitare aerice, rar hidroaerice, reactii inflamatorii fibroase, zone emfizematoase
• Localizare: cel mai frecvent segmente apical si dorsal lobi superiori si apical lobi inferiori
Sindromul cavitar se poate asocia si cu noduli acinari diseminati,
consecinta extinderii pe cale bronhogena.
3. Tuberculoza cavitara cronica
![Page 29: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/29.jpg)
Aspectul radiologia al cavernelor este in functie de stadiul in care se gasesc:
Caverna de gradul 1
Caverna de gradul 2
Caverna de gradul 3
Caverna de gradul 1: hipertransparenta cu contur anfractuos in masa infiltratului
![Page 30: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/30.jpg)
Caverna cu perete mai
net localizata subclavicular
drept
Caverna de gradul 2: are perete propriu, subtire si elastic, conturul mai net
![Page 31: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/31.jpg)
Intre caverna si hil bronhia de drenaj
Caverna de gradul 2
![Page 32: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/32.jpg)
Caverna de gradul 2
![Page 33: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/33.jpg)
Caverna de gradul 3: cavitate veche, net conturata, perete fibrozat; din cauza sclerozei cavitare poate avea forma neregulata; in jurul cavernei
leziuni sechelare.
![Page 34: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/34.jpg)
Caverna veche, net conturata, perete fibrozat, scleroza pericavitara
Caverna de gradul 3
![Page 35: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/35.jpg)
Aspecte radiologice ale TB cavitare
Caverne multiple in diferite stadii de evolutie
![Page 36: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/36.jpg)
Aspecte radiologice ale TB cavitare
![Page 37: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/37.jpg)
Aspecte radiologice ale TB cavitare
![Page 38: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/38.jpg)
Aspecte radiologice ale TB cavitare
Caverne, mici, multiple, aspect in “miez de paine“ in stadii diferite de evolutie
![Page 39: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/39.jpg)
Complicatiile TB cavitareComplicatiile TB cavitare
• PLEUREZIA SERO FIBRINOASA• SIMFIZE SI INGROSARI PLEURALE
(DUPA RESORBTIA EXUDATULUI)• EMPIEM PLEURAL
(INFECTAREA EXUDATULUI)• PNEUMOTORAX SPONTAN PARTIAL SAU TOTAL
(DESCHIDEREA IN PLEURA A UNEI CAVERNE JUXTAPLEURALE SAU ERODAREA PLEUREI VISCERALE DE UN NODUL LOCALIZAT SUBPLEURAL)
• DISEMINARILE DE TIP BRONHOGEN
![Page 40: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/40.jpg)
Complicatiile TB cavitareComplicatiile TB cavitare
Leziuni infiltrative tuberculoase LSSImagine mixta hidroaerica cu nivel orizontal hemitorace drept – empiem pleural
![Page 41: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/41.jpg)
Complicatiile TB cavitareComplicatiile TB cavitare
•Empiem stang de origine tuberculoasaLeziuni infiltrative extinse plaman drept
![Page 42: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/42.jpg)
Complicatiile TB cavitareComplicatiile TB cavitare
Opacitate lenticulara tangenta la peretele toracic, contur net convex spre parenchimul pulmonar
![Page 43: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/43.jpg)
Aspecte radiologice ale TB cavitare
Opacitati intinse, confluente, care delimiteaza caverne mici multiple. Imaginile cavitare se insotesc si de leziuni nodulare.
![Page 44: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/44.jpg)
Complicatiile TB cavitareComplicatiile TB cavitare
Hipertransparenta in absenta desenului pulmonar, plaman colabat la hil (camp pulmonar drept), leziuni infiltrative extinse (camp pulmonar stang)
![Page 45: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/45.jpg)
Complicatiile TB cavitareComplicatiile TB cavitare
•Leziuni infiltrativ cavitare bilateralPneumotorax drept
![Page 46: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/46.jpg)
Complicatiile TB cavitareComplicatiile TB cavitare
•Leziuni infiltrative extinse bilateralHidro-pneumotorax drept
![Page 47: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/47.jpg)
Complicatiile TB cavitare – diseminari bronhogeneComplicatiile TB cavitare – diseminari bronhogene
Opacitati micronodulare, contur difuz, imprecis delimitate cu tendinta la confluare ce delimiteaza mici zone de excavare “miez de paine”
![Page 48: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/48.jpg)
Complicatiile TB cavitare – diseminari bronhogeneComplicatiile TB cavitare – diseminari bronhogene
Diseminare bronhogena din LSD in LIS(diseminate de tip “Cardis”)
![Page 49: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/49.jpg)
Complicatiile TB cavitare – diseminari bronhogeneComplicatiile TB cavitare – diseminari bronhogene
Hipertransparenta cu excluderea functionala a
palmanului stang, cu atractia traheii spre stanga,
ascensionarea diafragmului si hiperinflatie
compensatorie a plamanului controlateral;
Plamanul drept prezinta leziuni infiltrative extinse si o imagine cavitara la nivelul
apexului
TUBERCULZA MULTIDROG REZISTENTA
![Page 50: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/50.jpg)
- Noduli de 1-3 mm diseminati in mai multe organe sau doar in plamani
- Diseminare limfatica sau arteriala- Complicatie a TB primare, secundare sau ca o afectiune
primitiva- Se insoteste de adenopatii- Mod de evolutie variat: acut, subacut, cronic- Radiologic: desen reticular fin sau noduli de 1-3 mm cu
distributie bilaterala cu dimensiuni egale, initial mai numerosi la nevelul bazelor, ulterior vizibili si in lobii superiori
4. Tuberculoza miliara
![Page 51: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/51.jpg)
Tuberculoza miliara – noduli miliari distribuiti uniform in ambele arii pulmonare
![Page 52: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/52.jpg)
Miliara generalizata subacuta si cronica
• Diseminarea este hematogena
• Noduli mai mari si dimensiuni inegale
• Distributie este mai ales perihilara, in etajele mijlocii si superioare
![Page 53: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/53.jpg)
- Au potential evolutiv bacilar ! - Sclerozele fibroase pot fi:
- GENERALIZATE
- LOCALIZATE
Leziunile pot fi:
- MINIME: - noduli stelati, calcificati localizati la varfuri
noduli Simon
- scleroze perihilare = adenopatii hilare+periadenita scleroasa
- MAJORE: - lobita ulcero-cazeoasa=opacitate densa, topografie lobara, in care se pot evidentia dilatatii bronsice sau focare de ramolisment;
Scleroze extensive mutilante - FIBROTORAX
5. Tuberculozele fibroase
![Page 54: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/54.jpg)
Fibroza posttuberculoasa
• Lobita retractila LSD insotita de leziuni fibronodulare cicatriciale extinse plaman stang
![Page 55: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/55.jpg)
Fibroza posttuberculoasa
• Lobita retractila LSS insotita de leziuni fibroase extinse plaman drept;
• Pahipleurita bazala stanga.
![Page 56: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/56.jpg)
FIBROTORAXUL- proces de scleroza cicatriciala definitiva care
intereseaza un plaman in intregime
• Proces de scleroza a intregului plaman drept
• Sdr. retractil al hemitoracelui stang
• Leziuni nodulare la nivelul plamanului stang
![Page 57: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/57.jpg)
- Radiologic: opacitate rotunda, ovalara, incapsulata, structura omogena sau neomogena, contur net, poate fi solitar sau multiplu
RADIOGRAFIILE SERIATE ARATA STABILITATEA LEZIUNII IN TIMP !
5. Tuberculomul
![Page 58: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/58.jpg)
Diagnosticul diferential al tuberculomului = diagnosticul nodului solitar pulmonar.
Cauze tumorale:• Tumori maligne: -carcinom bronhogenic -limfom pulmonar primitiv -metastaza unica -sarcom pulmonar• Alte tumori: -hamartom -carcinoid bronsic -leiomiom
Boli inflamatorii sau infectioase:• Infectie cu Nocardia• Chist hidatic• Abces pulmonar• Granulomatoza Wegener• Noduli reumatoizi• Pneumonie
![Page 59: Tuberculoza Pulmonara-Aspecte Radiologice](https://reader033.vdocuments.mx/reader033/viewer/2022061313/55cf9dfc550346d033b02580/html5/thumbnails/59.jpg)