Current Issue

2021 Vol.6 No.1 Published:28 February 2021

Guidelines and Consensus

Imaging diagnostic criteria for pulmonary tuberculosis Imaging Committee on Infections, Chinese Society of Radiology; Committee on Infectious Disease; Radiology Committee, Chinese Medical Doctor Association; Radiology of Infection, Inflammation, Chinese Research Hospital Association; Imaging Committee on Infections, Chinese Association of STD&AIDS Prevention; Imaging Group on Infections, Association of Infections Disease Hospital; Beijing Medical Imaging Technology Innovation Alliance 2021, 6 (1):  1-6.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.001 Abstract ( 788)    PDF (946KB) ( 1802 )    Pulmonary tuberculosis is a chronic contagious disease caused by the infection of mycobacterium tuberculosis. It is recognized as a major public health problem and one of the top ten causes of death worldwide. Early accurate diagnosis is the key to reduce the spread of pulmonary tuberculosis and lower the incidence and mortality. Therefore, it is of great significance to establish a set of imaging diagnostic criteria for tuberculosis. Based on the methodology formulated by evidence-based medicine guidelines and standards, this standard has been referred to the 2011 evidence grading standards of evidence-based medicine center of Oxford University and the methodology formulated by the working group recommendation of international grading of Recommendations Assessment, Development and Evaluation（GRADE）. Collectively, the final recommendation was formulated according to the tuberculosis diagnostic standards issued by the National Health and Family Planning Commission on November 9th, 2017. This standard covers the imaging manifestations, suspected cases, imaging diagnostic cases, diagnostic criteria and imaging differential diagnosis of primary pulmonary tuberculosis, hematogenous disseminated pulmonary tuberculosis, secondary pulmonary tuberculosis, tracheobronchial tuberculosis and tuberculous pleurisy, providing scientific evidence for the clinical imaging diagnosis and differential diagnosis of pulmonary tuberculosis.

Original Articles

Investigating value of machine learning in voxel-mirrored homotopic connectivity using functional magnetic resonance imaging for AIDS patients Fu Danhui, Deng Wenjuan, Ding Qianlin, Jin Guanqiao, Liu Lidong, Zhao Yang, Huang Shaobiao, Wu Nianning, Su Danke 2021, 6 (1):  13-17.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.003 Abstract ( 404)    PDF (943KB) ( 956 )    Objective To explore the diagnostic value of voxel-mirrored homotopic connectivity（VMHC） values in the assessment of HIV-related neurocognitive disorders using magnetic resonance resting state functional imaging based on machine learning. Methods The twenty seven AIDS patients without antiviral therapy (HIV group) and 14 normal volunteers (control group) were included. Taking the neuropsychological performance(NP) test as a reference standard, the HIV patients were grouped into the HIV-associated neurocognitive disorder（HAND ）,sed using DPARSF and PRoNTo software. Results The ten brain regions in which the VMHC index contributed the most difference between the AIDS patients and the control group included the bilateral paracentral lobule, the right supplementary motor area, the bilateral precuneus,the right inferior parietal gyrus, the left supplementary motor area, the left caudate nucleus, the right postcentral lobule, the left heschl gyrus. VMHC index was no significant between HAND group and non-HAND group. The VMHC values of the bilateral supplementary motor area,the right inferior parietal gyrus, the left caudate nucleus, the right postcentral lobule, the left heschl gyrus were related to clinical scales and cognitive scores. Conclusion VMHC value is a useful marker for HAND, which may contribute to the occurrence and development of HAND.

Comparison of two state-of-the-art assays for detecting 2019-nCoV nucleic acid Cai Kanru, Zhang Jieyun, Peng Yabo, Cheng Wenbing, Zhang Mingxia 2021, 6 (1):  18-21.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.004 Abstract ( 562)    PDF (1026KB) ( 1053 )    Objective To investigate the consistency of the two assays for the testing of SARS-CoV-2 nucleic acid. Methods 2019-nCoV nucleic acid were parallelly tested in sputum, anal swabs and nasal swabs from COVID-19 confirmed cases by A assays and B assay in the third people's hospital of Shenzhen. 539 results were retrospectively analyzed using consistency test. Four samples with Ct value >36 parallelly tested by two assay were selected for sequencing. Results The Kappa values of nucleic acid results from the two assay were 0.49 in sputum, 0.55 in nasal swabs, and 0.71 in anal swabs, respectively.The consistency rates for the nucleic acid in sputum, nasal swabs, and anal swabs were 100% when the Ct values were <34 parallelly tested by two assay. While, the corresponding consistency rates were 0% in sputum, 45% in nasal swabs, and 57.1% in anal swabs, respectively, when the Ct values were ≥ 34 parallelly tested by two assay. Nucleic acid was tested positively by sequence in the four samples with Ct values >36 parallelly tested by two assay. Conclusions The consistency of nucleic acid results tested by the two assays was low when Ct value was high (≥34), which implies that using single assay of them has the risk of false-negative. Parallelly testing the nucleic acid of 2019-nCoV is an alternative to increase testing accuracy. It is urgent to optimize the efficacy for the two assays.

Research on the application value of MSCT pixel index quantitative analysis in COVID-19 assessment Lan Bowen, Tang Runhui, Zhang Zhiyan, Chen Kangyin 2021, 6 (1):  22-26.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.005 Abstract ( 492)    PDF (1458KB) ( 807 )    Objective To explore the clinical value of quantitative analysis of multi-slice spiral CT (MSCT) pixel index (PI) in the first CT and disease course assessment of COVID-19. Methods The chest CT date of 48 patients diagnosed with COVID-19 in our hospital from January 22,2020 to March 1,2020 were collected. The Thoracic VCAR software was used for the pulmonary lobes segmentation and PI quantitative evaluation, PI values of pulmonary lope of <-700Hu, -700Hu — -300Hu, >-300Hu were measured. The characteristics of PI in the initial CT examination and the changes of PI among different stages（in 1st, 2nd, 3rd, 4th and beyond weeks）were analyzed. Results ①The difference of PI<-700Hu, PI-700Hu — -300Hu and PI>-300Hu between the lung lobe groups were found statistically significant (P>0.05). ②Comparison between each lung lobe group: the PI>-300Hu of right middle lobe was higher than that of right upper lobe (P<0.05); PI-700Hu — -300Hu and PI>-300Hu of bilateral lower lobe were higher than those of bilateral upper lobe and lower right middle lobe, PI<-700Hu of bilateral lower lobe were lower than that of bilateral upper lobe and right middle lobe (P<0.05), and the rest of the lung lobe pairwise comparison were not statistically significant(P>0.05). ③PI -700Hu — -300Hu and PI>-300Hu of whole lung were found highest in the second weeks after onset [11.41%(8.66%—19.24%)、2.47%(1.85%—4.36%)], while the PI -1024Hu — -300Hu of the whole lung was fount lowest[86.31%(74.70%—89.54%)]. Conclusion The PI of MSCT CT can quantitatively analyze the pulmonary exudation and consolidation of COVID-19 patients,from visual assessment to accurate quantification. Combined with conventional CT, it can be used for clinical diagnosis and follow-up treatment evaluation of COVID-19 patients.

Pulmonary CT findings for AIDS patients concomitant with multi-drug resistance tuberculosis Li Yu, Liu Xia, Zhou Jingru, Zou Jun, Lu Yibo 2021, 6 (1):  27-30.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.006 Abstract ( 441)    PDF (880KB) ( 761 )    Objective To investigate the CT features of multi- drug resistant tuberculosis(MDR-TB) in AIDS patients and in non-AIDS patients. and conduct comparative analysis to provide evidence for its clinical diagnosis and treatment. Method From December 2014 to April 2019, 25 cases of AIDS complicated with MDR-TB diagnosed in the Fourth People's Hospital of Nanning were collected as the observation group, and 50 cases of non AIDS patients with MDR-TB as the control group. Comparative analysis in CT manifestations of AIDS with MDR-TB and non-AIDS patients with MDR-TB were performed. Results In terms of lung field distribution, lesions in both of these two groups were mainly distributed in the whole lung of the two lungs with no statistically significant difference between two groups (15/25 vs 33/50, P>0.05). Regarding lesion morphology, the incidences of miliary and ground glass appearance in the observation group were significantly higher than those in the control group, while the incidences of nodular, patchy, spotty, streak appearance, caseous pneumonia/lung damage, calcification and cavity were significantly lower in the observation group than those in the control group (P<0.05). As for extrapulmonary manifestations, the incidence of pericardial effusion, mediastinal/hilar lymph node enlargement and tuberculosis in other parts of the body in the observation group was significantly higher than that of the control group, while the incidence of hilar mediastinal/lymph node calcification and pleural thickening was significantly lower than that of the control group(P<0.05), There was no significant difference in the occurrence of pleural effusion between the two groups (P<0.05). Conclusion The CT imaging findings of AIDS complicated with MDR-TB showed that the lesions had a wide range of distribution and usually involved the whole lung field.In terms of the morphology of the lesions, the ground glass appearance and the grainy appearance were the most characteristic changes of the lesions that were different from those of non-AIDS MDR-TB, and were more likely to be associated with mediastinal/hilar lymph node enlargement, pericardial thickening/pericardial effusion and pleural effusion.

A retrospective study of peginterferon α-2b combined with ribavirin in the treatment of HIV/HCV con-infection Liu Min, Zeng Qin, Pan Liang, Zhang Huifen, Huo Qin, Chen Yaokai 2021, 6 (1):  31-34.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.007 Abstract ( 617)    PDF (903KB) ( 641 )    Objective To investigate the anti-HCV treatment with peginterferon α-2b combined with ribavirin (PR), induced virological response, liver dysfunction and adverse drug reactions in HIV/HCV co-infected patients. Methods Clinical data of HIV/HCV co-infected patients in our hospital were collected,and comparative analysis in the biochemical changes, virological changes and immunological indices alteration between patients treated with PR regimen and those without anti-HCV treatment were performed. Result There were 56 cases with HIV/HCV co-infection, including 26 cases (46.4%) treated with PR regimen and 24 cases (42.9%) without anti-HCV treatment. Among them, 16 cases (61.5%) receiving PR regimens have completed the 24-week cycle of treatment. At the end of 24 weeks after the initiation of anti HCV treatment, all 16 patients were presented with HCV RNA <15IU/ml. The proportion of patients with abnormal liver function was decreased from 68.8% prior to the treatment to 25% at the completion of treatment (P<0.05). After the completion of 24-week treatment, FIB-4 score of patients receiving PR regimen was significantly lower than that of untreated patients (P<0.05). CD4+T cell count in the treatment group was significantly higher than that of untreated patients(P<0.05). Conclusions PR regimen can be used for the treatment of HIV/HCV co-infected patients with good virology, hematological and immunological responses.

CT features of solitary pulmonary non-caseous tuberculoma: diagnosis and differential diagnosis Wei Liangui, Guan Chunshuang, Chen Budong, Lyu Zhibin, Xue Ming, Zhou An, Xu Donghai, Lyu Yan, Xie Ruming 2021, 6 (1):  35-39.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.008 Abstract ( 564)    PDF (3015KB) ( 777 )    Objective To retrospectively analyze the imaging features of solitary pulmonary non-caseous tuberculoma (PNCTB) on CT, and to differentiate from other solitary nodules. Methods The twenty-eight cases of PNCTB, 50 cases of peripheral lung cancer, 16 cases of hamartoma, 18 cases of sclerosing hemangioma, and 33 cases of spherical pneumonia were collected. Two chest radiologists evaluated CT images. The evaluation parameters included lesion size, distribution, satellite lesion, lobulated shape, spiculated sign, vacuole sign and enhancement degree. Results The twenty-eight cases of PNCTB showed no statistical difference with peripheral lung cancer, hamartoma, sclerosing hemangioma, or spherical pneumonia in the lesion size and lobe distribution. There was statistical difference between PNCTB and peripheral lung cancer on the " lobulated shape " and " spiculated sign ", but the pleural indentation sign; only 17.86% of PNCTB had satellite lesions, which had statistical significance compared with spherical pneumonia (90.90%). The satellite lesions of PNCTB showed tree-in-bud sign while spherical pneumonia showed patchy shadow. After contrast-enhanced scan, 64.29% of PNCTB showed heterogeneous enhancement, which was not statistically significant with peripheral lung cancer and spherical pneumonia, but sclerosing hemangioma showed homogeneous enhancement, which could be differentiated from PNCTB. 71.43% of PNCTB had enhancement degree with 16-20 HU, which was statistically significant compared with other nodules in this study. Conclusion PNCTB could be highly suspected when solitary pulmonary nodule with inhomogeneous enhancement and CT value below 20 HU. The possibility of PNCTB diagnosis is greatly increased when satellite focus appears. It is helpful to differentiate solitary nodules from other solitary nodules when there are vacuole sign, cavity, fat, calcification, spiculated sign, lobulated shape, or pleural indentation sign.

Diagnosis value of CTVE in AIDS combined with bronchial tuberculosis: a comparative analysis with bronchoscopy Liu Te, Yang Gendong, Liu Wenhao, Zheng Guangping, Zeng Xuan, Li Cuizhu, Peng yu, Zhang Hui, Wang Zhang 2021, 6 (1):  40-44.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.009 Abstract ( 487)    PDF (1710KB) ( 650 )    Objective To explore clinical value of CT virtual endoscopy（CTVE）imaging in the diagnosis of AIDS combined with bronchial tuberculosis,by contrast analysis with bronchoscopy. Methods Forty-three patients with confirmed AIDS and clinical manifestations with bronchial tuberculosis underwent CT thin-slice continuous volume scan, CT traversal images and CTVE images were used to evaluate bronchial lesions, and compared with bronchoscopy, the examination results were analyzed by statistical methods. Results For the detection rate of bronchial tuberculosis, traversal images and CTVE images were 62.8%(27/43) and 83.7%(36/43), respectively (P=0.021), and the difference was statistically significant. Compared with bronchoscopy, CTVE had no statistical significance (P>0.375). Conclusions CTVE has a higher diagnostic accuracy for bronchial tuberculosis, and it is also a non-invasive examination method, which is easy to be accepted by AIDS patients, and high clinical application value and broad clinical application prospects.

Analysis of CT features of old pulmonary tuberculosis recurrence Fang Weijun, Han Yuanyuan, Song Min, Liu Wen, Liu Zhihui 2021, 6 (1):  45-48.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.010 Abstract ( 604)    PDF (1587KB) ( 1475 )    Objective To investigate the CT features and charac-teristics of relapsing patients with old pulmonary tuberculosis,and to provide evidence for its early diagnosis. Methods A total of 100 patients with old pulmonary tuberculosis in Guangzhou Chest Hospital diagnosed by clinical and laboratory from April 2009 to December 2019 were collected, among which 40 patients with reburning were reburning group and 60 patients without reburning were nonreburning group. The CT features of the two groups were compared and analyzed, and the CT features of relapsing patients with old pulmonary tuberculosis were summarized. Results The incidence of pulmonary lesion involving lobes of both lungs in reburning group and nonreburning group was 22.50%（9/40）and 65.00%（39/60）, 60.00%（24/40）and 25.00%（15/60）, 17.50%（7/40）and 10.00%（6/60）22.50%(9/40), respectively. There were significantly difference between the two groups(χ2 values:17.37, 12.36 and 5.32, respectively;P value：<0.0001,0.0004 and 0.0211, respectively). The detection rate of clear margin, calcification, hilar mediastinal lymph nodes and pleural thickening was compared between the two groups, there were no significant differences (χ2 values: 2.025, 3.255, 0.0071 and 0.0631, respectively;P values:0.1548, 0.0712, 0.9330 and 0.8017, respectively). There were significantly difference in the detection rate of imaging signs of bronchial tuberculosis, consolidation and Cavitation, bronchiectasis, pulmonary bullae (χ2 values: 4.438, 6.250, 4.001 and 3.177,respectively;P value：0.0351, 0.0124, 0.0455 and 0.0015, respectively). Conclusion CT scan of patients in the reburning group showed a wide range of pulmonary lesions, and the incidence of pulmonary lesions combined with bronchial tuberculosis consolidation, cavity bronchial dilatation and pulmonary bullae was higher than that in the nonreburning group, Which can make a contribution for early clinical diagnosis and treatment.

Correlation between computed tomographic and 3T magnetic resonance imaging findings of parenchymal lung diseases Yan Qinqin, Shen Jie, Lu Shuihua, Shan Fei, Shi Yuxin 2021, 6 (1):  49-53.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.011 Abstract ( 543)    PDF (1152KB) ( 1063 )    Objective To optimize the pulmonary 3T magnetic resonance sequences and evaluate the diagnostic performance of parenchymal lung diseases. Methods 178 patients underwent chest 3T-MRI including star-volumetric interpolated breath-hold(Star-VIBE), VIBE, fast BLADE turbo spin echo(fBLADE TSE) and three-dimension sampling perfection with application optimized contrasts using different flip angle evolution(3D-SPACE). Image quality and detection rate of four sequences from random 60 patients were compared. And CT as reference was used for evaluation of detection. Results SNR of Star-VIBE was statistically higher than VIBE. Comparisons of CNR and 5-point scores had no difference. SNR and 5-point scores of fBLADE TSE was statistically higher than 3D-SPACE. The CNR of fBLADE TSE was lower than 3D-SPACE. Detection rate between Star-VIBE and VIBE, fBLADE TSE and 3D-SPACE had no difference. The sensitivity of nodules <6mm, 6-8mm, 8-10mm and ≥10mm was 90.5%, 95.6%, 100% and 100%. 3T-MRI sensitivity of calcified nodules was 80.3%. 3T-MRI was comparable to CT in detecting consolidation, ground-glass opacities, cavity, lobulation, spiculation, stripe, pleural reaction, tree-in-bud sign, miliary nodules, satellite lesions. 3T-MRI was inferior to CT in detection of pleural indention and bronchiectasis. 3T-MRI was superior to present caseous necrosis, liquefaction, mucus plug and obstructive pneumonia. Conclusions free-breathing Star-VIBE and fBLADE TSE can provide high-quality images. And 3T-MRI is comparable to CT for pulmonary parenchyma lesions and has advantages of identifying caseous necrosis, liquefaction, mucus plug and obstructive pneumonia.

CT findings and clinical characteristics of pulmonary tuberculosis with increased lesions Zhu Yi, Ren Yan, Cheng Xi, Liu Rongrong, Liu Jing, Tang PeiJun, Li Min 2021, 6 (1):  54-57.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.012 Abstract ( 551)    PDF (1224KB) ( 964 )    Objective To analysis the CT signs and clinical features of increased lesions during the treatment of pulmonary tuberculosis. Methods Forty-eight pulmonary tuberculosis patients with increased focus admitted to the Suzhou Fifth People's Hospital from December 2015 to December 2018 were collected, and the CT imaging and clinical data of the pre progression lesions and post-progression lesions of the above patients were retrospectively analyzed and summarized. Results Of the 48 patients, 46(95.83%) patients had increased lesions in the same lung segment as the pre progression lesion, 14(29.17%) patients had increased lesions in the same lobe as the pre progression lesion.29(60.42%) patients increased in medium amount, and 17(35.42%) patients increased in small amount. The main CT signs of increased lesions were patch shadow in 37 cases (77.08%), nodule in 26 cases (54.17%), tree-in-bud sign in 22 cases (45.83%), consolidation shadow in 20 cases (41.67%), ground glass opacity in 13 cases (27.08%). There were statistically significant differences in nodule, tree-in-bud sign, cavity, localized emphysema, calcification and cord focus before and after the lesion progression (χ²=11.35、11.51、13.85、9.04、21.26、51.4,P<0.05). During the period of increased lesions, the main clinical symptoms were cough in 40(83.33%) patients, expectoration in 33(68.75%) patients and fever in 12(25.00%) patients. The positive or abnormal indexes of laboratory test were as follows: 10(20.83%) patients of acid fast bacilli, 10(20.83%) patients of Mycobacterium tuberculosis, 6(12.50%) patients of drug resistance, 7(14.58%) patients of decreased leukocyte index and 6(12.50%) patients of fungus detection. Conclusion In the treatment of pulmonary tuberculosis, the increased lesions is closely related to the distribution of the pre progression lesions, and the increased lesions morphology is mainly CT signs of active pulmonary tuberculosis; the clinical manifestations are mainly cough and expectoration, it is need to carry out relevant etiological examination, combined with CT imaging, which can provide help for the adjustment of the clinical treatment plan.

Review

The value of detecting cryptococcal antigen in the diagnosis of cryptococcosis Chen Li, He Xiaoqing, Chen Yaokai 2021, 6 (1):  58-61.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.013 Abstract ( 720)    PDF (879KB) ( 1791 )    Cryptococcosis is an invasive fungal disease caused by cryptococcosis,it is a common cause of infection and death among AIDS patients and solid organ transplant recipients.In the past ten years, the diagnostic methods for cryptococcosis have ranged from fungal culture and ink staining to the current detection of cryptococcal capsular antigen (CrAg).CrAg detection is simple and fast, inexpensive, high sensitivity and specificity, so it is widely used worldwide.The World Health Organization recommends CrAg screening for high-risk groups and preemptive treatment of CrAg-positive patients to reduce the mortality rate.This article reviews the value of cryptococcal capsularantigendetecting in the diagnosis of cryptococcosis.

Imaging manifestations of liver perivascular lucency and its clinical significance Wang Xu, He Yulin 2021, 6 (1):  62-64.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.014 Abstract ( 691)    PDF (1124KB) ( 899 )    Perivascular lucency (PVL) is an imaging sign that reflects abnormal circulation of liver lymph fluid, It is especially common in patients with viral hepatitis and cirrhosis; The pathological basis is obstruction of hepatic lymphatic fluid return and increased production of hepatic lymphatic fluid. With the rapid development of medical imaging technology, the display capability of PVL has improved significantly, CT and MRI are preferred, especially MRI; The main manifestations are low density (CT) and long T1 long T2 signal (MRI) shadows around the trunk and branches of the portal vein, forming halo or orbit-like changes, and no enhancement in enhanced scans. The appearance of PVL strongly suggests the worsening of viral hepatitis or cirrhosis. In this article, by reviewing the relevant literature of PVL in recent years, a comprehensive description of the pathological mechanism, imaging manifestations, and clinical significance of this sign is made.

Pulmonary multi-drug resistant tuberculosis: a radiological review Ma Luyao, Zheng Qiuting, Lu Puxuan, Li Hongjun, Fleming YM Lure, Yin Xiaoping, Guo Lin 2021, 6 (1):  65-72.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.015 Abstract ( 472)    PDF (916KB) ( 596 )    Drug-resistant tuberculosis is a respiratory infectious disease caused by drug-resistant Mycobacterium tuberculosis, which seriously threatens human health. The disease is poorly treated, especially multidrug-resistant tuberculosis (MDR-TB).Therefore, timely detection of MDR-TB can enable patients to be better managed and treated.Based on published literature, this article searches the PubMed database in October 2019. The search keyword combination is "(multidrug-resistant tuberculosis) AND (CT or radiograph or imaging or X-ray or computed tomography)", while searching Wanfang Medical database, the search keyword combination is "(multidrug-resistant tuberculosis) and (CT or radiology or imaging or X-ray)" to analyze and summarize the progress of MDR-TB in imaging research.The published literature shows that MDR-TB patients have no definite chest imaging diagnosis basis. When the chest X-ray and CT, the patient appears lung cavity, especially the larger the cavity or the thicker the cavity wall, the more prompt It is the possibility of MDR-TB, and the imaging doctor should doubt the possibility of MDR-TB when there is the appearance of damaged lung imaging.At the same time, the analysis results show that CT is the main imaging method, and X-rays have certain limitations. Positron Emission Tomography-Computed Tomography (PET-CT) is currently only applicable to assess MDR-TB treatment. The result description is not concise, you can refer to how other similar articles are described. Using artificial intelligence (AI) technology for MDR-TB auxiliary diagnosis will become a new key research direction in the future.

Education Fields

Interpretation of imaging diagnostic criteria of pulmonary tuberculosis Fang Weijun, He Yulin, Xu Chuanjun, Lu Yibo, Lyu Shengxiu, Wang Xiaoyi, Chen Budong, Yang Yuxin, Li Hongjun, Lu Puxuan 2021, 6 (1):  73-78.  DOI: 10.19871/j.cnki.xfcrbzz.2021.01.016 Abstract ( 899)    PDF (889KB) ( 1763 )    Tuberculosis is still a major infectious disease that endangers human health today,, especially in the context of the COVID-19 epidemic, maintaining and strengthening of TB services is an important part of the overall process of achieving universal health coverage and restoring health systems, and can ensures the collaborative prevention and control of TB and COVID-19.The establishment and publication of the diagnostic criteria of pulmonary tuberculosis is of great significance to the accurate classification, imaging diagnosis, differential diagnosis and therapeutic evaluation of pulmonary tuberculosis, at the same time, it is a perfect and effective supplement to the national diagnostic criteria of pulmonary tuberculosis.Diagnostic criteria for imaging of pulmonary tuberculosis are based on evidence-based medicine guidelines and standard-setting methodologies, the recommended imaging methods for pulmonary tuberculosis include X-ray chest film (evidence level Ⅲ, recommended intensity: strong) and CT (evidence level Ⅲ, recommended intensity: strong).It is suggested that the history, clinical manifestation, laboratory examination and histopathological examination are the basis for the diagnosis of pulmonary tuberculosis.According to the national tuberculosis diagnostic criteria and the classification of pulmonary tuberculosis, the imaging classification of pulmonary tuberculosis is recommended as follows: primary pulmonary tuberculosis, hematogenous pulmonary tuberculosis, secondary pulmonary tuberculosis, tracheobronchial tuberculosis and tuberculous pleurisy, the main imaging manifestation of pulmonary tuberculosis were systematically described, which is helpful for clinical diagnosis and provides a basis for accurate diagnosis and treatment.