[Contribution of imaging in the diagnosis and follow-up of thoracic tuberculosis]. / Apport de l'imagerie dans le diagnostic et le suivi de la tuberculose thoracique.

ABSTRACT

Imaging as an essential tool for diagnosis and follow-up of pulmonary tuberculosis. Standard radiography is of prime importance, while in a large number of cases computed tomography (CT) and in selected exceptional cases with spinal involvement, magnetic resonance imaging (MRI) offer further precisions. CT is particularly important for diagnosis because of a better spatial visualization of the lesions and a better evaluation of their structure, both in the parenchyma and in the mediastinum; this indication is especially important in black Africans and in AIDS patients. CT can also be used to guide biopsies. It is particularly important for prognosis in the acute phase even though the tuberculosis may be patent and the bacterial strain identified. There is however still room for discussion on the balance between requirements, usefulness and cost. Finally CT is an excellent means of conducting long-term follow-up of sequellae as long as it is performed at least one year after the initial manifestations of the disease.