结核病的诊断有两个世界。在一个世界,痰涂片镜检是唯一可用的方法。通常在病人支付的起的情况下,可能还有一些放射性的方法。在另一个世界,有所有可用的现代化技术,包括痰培养、核酸扩增、分子诊断和一些尖端的放射性技术,如计算机断层扫描和正电子发射断层扫描。在这两个世界,结核病的诊断或误诊有很大的不同。本文概述了结核病的临床、影像学、分子生物学和免疫学诊断,并着重介绍结核病诊断常见的困难和缺陷。 There are two worlds of tuberculosis diagnoses. In one world, sputum smear microscopy is the only method available. There may be some radioactive methods, usually at the patient’s expense. In another world, there are all available modern technologies, including sputum culture, nucleic acid amplification, molecular diagnostics and some cutting-edge radiological techniques such as computed tomography and positron emission tomography. In both worlds, the diagnosis or misdiagnosis of tuberculosis is very different. This article provides an overview of the clinical, radiological, molecular and immunological diagnoses of tuberculosis and highlights the common pitfalls and shortcomings of tuberculosis diagnosis.