Computed Tomography in Diagnosis of Lesions of Pulmonary Tuberculosis: Computed Tomography in Pulmonary Tuberculosis

. Kailash; . Komal; Sohbia  Muir; Marya  Hameed; Sumera  Mahar; Zeeshan  Ghias Khan

doi:10.54393/pjhs.v4i03.620

Authors

. Kailash Department of Radiology, SMBB Institute of Trauma, Karachi, Pakistan
. Komal Department of Radiology, SMBB Institute of Trauma, Karachi, Pakistan
Sohbia Muir Department of Radiology, SMBB Institute of Trauma, Karachi, Pakistan
Marya Hameed National Institute of Child Health, Karachi, Pakistan
Sumera Mahar National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan
Zeeshan Ghias Khan Department of Radiology, DHQ Hospital, Gilgit, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i03.620

Keywords:

Chest X-Ray, Imaging Techniques, Lungs Consolidation, Lymphadenopathy, Pleural Effusion

Abstract

Pulmonary tuberculosis (MTB) is dangerous bacterial infection primarily affecting lungs and is capable of infecting everyone exposed to Mycobacterium tuberculosis. AFB and CXR are useful preliminary investigative tools, but CT scan are invaluable diagnostic tool for establishing a diagnosis and monitoring disease activity. Objectives: To diagnose the lesions of PTB and assess the CT scan findings in AFB-positive patients. Methods: The AFB-positive patients were examined using CT scan to reveal their mediastinal and pulmonary pathological conditions and activities and disease propagation using imaging technology of CT scan. In cases of PTB with lymphadenopathy, 50cc of non-ionic contrast was administered intravenously to examine the low attenuation area. Results: The findings of CT scan regarding micronodules, nodular masses and other foci and lymphadenopathy were scrutinized, and major diagnostic CT scan findings were Centrilobular nodules (97.40%), Parenchymal nodules (84.43%), Paratracheal and mediastinal lymphadenopathy (74.85%), air space consolidation and paucity (62.07%), Pulmonary calcification (31.73%), Pleural effusion (29.34%) and Bronchiectasis (12.77%). Conclusions: CT scan is the most sensitive and accurate tool for diagnosis confirmation and disease activity evaluation. In addition, it details the abnormalities and prognosis of organ deformity in PTB patients.

References

Anna R, Frank H, Michael ST, Pearson GDN. Radiographic appearance of pulmonary tuberculosis: Dogma disproved. American Journal of Roentgenology. 2015 May; 204 (5): 974-8. doi: 10.2214/AJR.14.13483.

Bhalla AS, Goyal A, Guleria R, Gupta AK. Chest tuberculosis: Radiological review and imaging recommendations. Indian Journal of Radiology and Imaging. 2015 July; 25(3): 213-25. doi: 10.4103/0971-3026.161431.

Devi RKJ and Singh KHM. Computed tomography thorax- role in the diagnosis of pulmonary tuberculosis. Journal of Evolution of Medical and Dental Sciences. 2020 Feb; 9(07): 422-7. doi: 10.14260/jemds/2020/96.

Boushab MB, Ould-Bahiya SY, Mamoudou S, Taraore AM, Basco LK. Contribution of computed tomography in the diagnosis of pulmonary tuberculosis at Kiffa regional hospital, Assaba. International Journal of Pulmonology and Respiratory Science. 2018 May; 3(5): 1-5. doi: 10.19080/IJOPRS.2018.03.555624.

Wang Y, Shang X, Wang L, Fan J, Tian F, Wang X, et al. Clinical characteristics and chest computed tomography findings related to the infectivity of pulmonary tuberculosis. BMC Infectious Diseases. 2021 Nov; 21(1): 1197. doi: 10.1186/s12879-021-06901-2.

Kim H, Kim HY, Goo JM, Kim Y. Lung cancer CT screening and Lung-RADS in a tuberculosis-endemic country: the Korean lung cancer screening project (K-LUCAS). Radiology. 2020 July; 296(1): 181–8. doi: 10.1148/radiol.2020192283.

Cui EN, Yu T, Shang SJ, Wang XY, Jin YL, Dong Y, et al. Radiomics model for distinguishing tuberculosis and lung cancer on computed tomography scans. World Journal of Clinical Cases. 2020 Nov; 8(21): 5203–12. doi: 10.12998/wjcc.v8.i21.5203.

Behera G, Dei KL, Mania RN, Naik HK. Acute radiological change in adult pulmonary tuberculosis. Indian Journal of Tuberculosis. 2002 July; 49(3): 157-8.

Naseem A, Saeed W, Khan S. High Resolution Computed Tomographic Patterns in Adults with Pulmonary Tuberculosis. Journal of College of Surgeons and Physicians Pakistan. 2008 Nov; 18(11): 703-7.

Ors F, Deniz O, Bozlar U, Gumus S, Tasar M, Tozkoparan E, et al. High-resolution CT findings in patients with pulmonary tuberculosis: correlation with the degree of smear positivity. Journal of Thoracic Imaging. 2007 May; 22(2): 154-9. doi: 10.1097/01.rti.0000213590.29472.ce.

Li K, Jiang Z, Zhu Y, Fan C, Li T, Ma W et al. A valuable computed tomography based new diagnostic tool for severe chest lesions in active pulmonary tuberculosis: combined application of influencing factors. Science Reports. 2020 Feb; 10(1): 2023. doi: 10.1038/s41598-020-59041-z.

Kombila UD, Mbaye FB, Ka W, NO TB. Clinical and radiological characteristics of pulmonary tuberculosis in tobacco smokers. Revue des Maladies Respiratoires. 2018 Feb; 35(5): 538-45. doi: 10.1016/j.rmr.2017.04.006.

Murthy SE, Chatterjee F, Crook A, Dawson R, Mendel C, Murphy ME, et al. Pretreatment chest x-ray severity and its relation to bacterial burden in smear positive pulmonary tuberculosis. BMC Medicine. 2018 Dec; 16(1): 1-1. doi: 10.1186/s12916-018-1053-3.

Altet N, Latorre I, Fuentes MAJ, Maldonado J, Molina I, Diaz YG, et al. Assessment of the influence of direct tobacco smoke on infection and active TB management. PLoS One. 2017 Aug; 12(8): e0182998. doi: 10.1371/journal.pone.0182998.

Carlesi E, Orlandi M, Mencarini J, Bartalesi F, Lorini C, Bonaccorsi G, et al. How radiology can help pulmonary tuberculosis diagnosis: analysis of 49 patients. Radiology Medicine. 2019 Sep; 124(9): 838-45. doi: 10.1007/s11547-019-01040-w.

O’Donnell MR, Jarand J, Loveday M, Padayatchi N, Zelnick J, Werner L, et al. High incidence of hospital admissions with multidrug-resistant and extensively drug-resistant tuberculosis among South African health care workers. Annals of Internal Medicine. 2010 Oct; 153(8): 516–22. doi: 10.7326/0003-4819-153-8-201010190-00008.

Malaviya AN, Kapoor S, Garg S, Rawat R, Shankar S, Nagpal S, et al. Preventing tuberculosis flare in patients with inflammatory rheumatic diseases receiving tumor necrosis factor-alpha inhibitors in India. An audit report. Journal of Rheumatology. 2009 July; 36(7): 1414-20. doi: 10.3899/jrheum.081042.

He W, Chen BD, Lv Y, Zhou Z, Xu JP, Lv PX, et al. Use of low-dose computed tomography to assess pulmonary tuberculosis among healthcare workers in a tuberculosis hospital. Infectious Diseases of Poverty. 2017 Apr; 6(02): 90-9. doi: 10.1186/s40249-017-0274-6.

Hatipoğlu ON, Osma E, Manisali ME, Uçan ES, Balci P, Akkoçlu A, et al. High resolution computed tomographic findings in pulmonary tuberculosis. Thorax. 1996 Apr; 51(4): 397-402. doi: 10.1136/thx.51.4.397.

Majmudar DK and Rajput DK. Role of HRCT in diagnosing disease activity in pulmonary tuberculosis. International Journal of Contemporary Medical Research. 2017 Aug;4 (8): 1724-7.

Nachiappan AC, Rahbar K, Shi X, Guy ES, Mortani Barbosa EJ Jr, Shroff GS et al. Pulmonary Tuberculosis: Role of Radiology in Diagnosis and Management. Radiographics. 2017 Jan; 37(1): 52-72. doi: 10.1148/rg.2017160032.