Abstract: Due to its difficulties in diagnosis and treatment and high case fatality rate, drug-resistant pulmonary tuberculosis is identified by the WHO as one of the three major challenges in tuberculosis prevention and control, and it is also a major public health problem.. To this end, the Chinese Professional Committee of Infection and Inflammation Radiology and other institutions, organized more than 40 influential experts at home and abroad engaged in basic research and clinical related of drug-resistant tuberculosis, the Expert consensus on imaging diagnosis of drug-resistant pulmonary tuberculosis was compiled. Expert consensus on imaging diagnosis of drug-resistant tuberculosis is based on the assessment of evidence-based medicine and referring to the graded consensus guidelines on evidence quality and recommendation strength. Recommendation of imaging examination for drug-resistant tuberculosis (recommendation 1-5), including chest X-ray (DR) as the preferred screening method for drug-resistant pulmonary tuberculosis (level of evidence: Ⅲ, strength of recommendation: strong), and a common means of efficacy evaluation (level of evidence: Ⅳ, strength of recommendation: strong). CT is the main means of diagnosis of drug-resistant pulmonary tuberculosis (level of evidence: Ⅳ, strength of recommendation: strong). Based on the analysis of the imaging data of drug-resistant pulmonary tuberculosis, the CT imaging findings of drug-resistant pulmonary tuberculosis were described, including expert consensus indicating the main manifestations and characteristics of single drug resistance (including rifampin resistance), multidrug-resistant pulmonary tuberculosis (MDR-PTB) [including polydrug-resistant pulmonary tuberculosis (PDR-PTB)], and extensive drug-resistant pulmonary tuberculosis(including pre-extensive drug-resistant pulmonary tuberculosis) (recommendations 6-12). At the same time, the expert consensus described the key points of imaging differentiation between drug-resistant pulmonary tuberculosis and non-tuberculosis pulmonary disease, pulmonary aspergillosis and pulmonary cryptococcal disease. It provides a basis for the accurate diagnosis and guidance of clinical imaging of drug-resistant tuberculosis. This article interprets the expert consensus on imaging diagnosis of drug-resistant tuberculosis in order to help clinicians diagnose drug-resistant tuberculosis.

Key words: Tuberculosis, Drug drug-resistant, Computed tomography, Imaging diagnosis, Expert consensus, Interpretation