HIV AIDS CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]; Associate Editors-in-Chief: Ujjwal Rastogi, MBBS; Ammu Susheela, M.D. [4]

Overview

CT scans of chest are important part of diagnosis in HIV patients having pulmonary symptoms. It has an advantage over X-Ray in being more sensitive in detection of early interstitial lung disease, lymphadenopathy, and nodules.

CT

In HIV patients, nodules can result from bacterial infection (pneumonia or mycobacterial disease) or malignancy (most common being lymphoma). Nodules can be with or without cavitation. CT-guided transthoracic needle biopsy is used to make a definitive diagnosis.

A prospective study done in 30 patients comparing the accuracy of high resolution CT in distinguishing between Pneumocystis carinii pneumonia and non- Pneumocystis carinii pneumonia in AIDS patients stated that the sensitivity, specificity, positive predictive and, negative predictive values of the HRCT for the diagnosis for PCP were 100, 83.3, 90.5 and 100 percent, respectively.

HRCT fndings, that are suggestive of PCP are :

• Diffuse or ground glass pattern predominately in the upper lobes with or without cystic change.

HRCT fndings, that are not suggestive of PCP are :

• "Tree in bud" appearance.
• Consolidation.
• Bronchiectasis.
• Lymphadenopathy.

Image courtesy of Dr Paresh K Desai , Radiopedia. (original file [1] Creative Commons BY-SA-NC

Image courtesy of Dr Frank Gaillard, Radiopedia. (original file [2] Creative Commons BY-SA-NC