Abstract: Drug-resistant tuberculosis, a TB caused by Mycobacterium tuberculosis, is a major respiratory infection that currently threatens human health. Globally, WHO reported 160,684 cases of MDR/RR-TB in 2017, with 139,114 cases receiving treatment. About 47% of drug-resistant TB patients come from India (24%), China (13%) and Russia (10%). At the same time, about 230,000 MDR/RR-TB patients died. In order to effectively standardize the prevention, diagnosis and treatment of drug-resistant tuberculosis, it has been divided into two categories, new drug-resistant TB and previously treated drug-resistant TB, according to the laboratory bacteriology and the cause of drug resistance. While based on the degree of drug resistance, the categories could also be single-drug resistance, multidrug resistance, poly-drug resistance, extensively drug resistance and rifampicin resistance. In this paper, the imaging manifestations of rifampicin resistance, multidrug resistance and XDR-TB were described with representative images of CT and X-rays. Three kinds of drug-resistant pulmonary tuberculosis have some imaging characteristics, mainly manifested as multiple thick wall voids in the lungs, different sizes of the nodule shadow, patchy real changes, fiber stripe shadow, lymph node enlargement and pleural effusion. The lesions involved a wide range areas and long extended time which can cause damaged lungs. Keeping track of the incidence, fatality rate and clinical classification as well as understanding the imaging features of the main types of drug-resistant pulmonary tuberculosis is helpful to guide the clinical diagnosis, treatment and evaluation of curative effect, and to reduce the incidence and fatality rate.

Key words: MDR-TB, Classification, Diagnosis, Radiology