High resolution chest CT in patients with pulmonary tuberculosis: Characteristic findings before and after antituberculous therapy

doi:10.1016/j.ejrad.2007.07.009

European Journal of Radiology

Volume 67, Issue 1, July 2008, Pages 100-104

https://doi.org/10.1016/j.ejrad.2007.07.009 Get rights and content

Abstract

Objective

The purpose of this study was (a) to describe HRCT findings for pulmonary tuberculosis before and after treatment, and (b) to evaluate the possible use of HRCT to assess disease activity.

Patients and methods

We prospectively studied 52 patients with newly diagnosed pulmonary tuberculosis that was proven bacteriologically. HRCT scans were performed before and after treatment.

Results

Micronodules, nodules, tree-in-bud appearance, consolidation, and cavities were the most common HRCT findings seen in active pulmonary tuberculosis. The disappearance of tree-in-bud appearance, pleural effusion and the presence of fibrotic change appear to be indications of the effectiveness of treatment. HRCT can differentiate old fibrotic lesions from newly active tuberculous lesions.

Conclusions

HRCT may be helpful in the diagnosis of pulmonary tuberculosis and may be useful in the assessment of the efficacy of anti-tuberculous treatment.

Introduction

Chest radiography remains the first choice for initial evaluation of patients with pulmonary tuberculosis [1]. Computed tomography (CT) is superior to chest radiography in evaluating many chest diseases, and many CT features of pulmonary tuberculosis have been described [2], [3], [4]. In recent years, high resolution computed tomography (HRCT) has been found to be superior to chest radiography and standard CT in the assessment of pulmonary parenchymal disease [5], [6]. Using these advantages of HRCT, we studied patients with pulmonary tuberculosis in assessing the contribution of HRCT towards the evaluation of tuberculosis. The various HRCT findings for pulmonary tuberculosis and their changes after treatment are not yet established. The purpose of this study was (a) to describe HRCT findings for pulmonary tuberculosis before and after treatment, and (b) to evaluate the possible use of HRCT to assess disease activity. We used HRCT to prospectively study 52 patients with newly diagnosed pulmonary tuberculosis.

Section snippets

Patients and methods

From January 2001 to December 2003, 83 consecutive patients were evaluated for suspicion of pulmonary tuberculosis using HRCT. Inclusion criteria for this study were: (1) newly diagnosed pulmonary tuberculosis with no history of tuberculosis before, or, receipt of anti-TB treatment for less than 2 weeks. (2) Bacteriologically confirmed tuberculosis with positive sputum culture of Mycobacterium tuberculosis. (3) Human immunodeficiency virus (HIV) antibody must be negative. (4) Patients must be

Results

HRCT findings in our patients with pulmonary tuberculosis before and after treatment are summarized in Table 1.

Discussion

In cases of suspected pulmonary tuberculosis, it is often necessary to decide whether to start treatment before the results of TB cultures. The decision has to be based on clinical and radiologic evidence. In this situation, HRCT may enable physicians to make a presumptive diagnosis of active pulmonary tuberculosis and thus start anti-tuberculous chemotherapy sooner.

In this study, we found micronodules in 100% of patients. Micronodules are most often seen in the acute early stages of

Acknowledgments

This study was reviewed and financially supported by Buddhist Tzu Chi General Hospital.

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High resolution computed tomographic findings in pulmonary tuberculosis
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High resolution chest CT in patients with pulmonary tuberculosis: Characteristic findings before and after antituberculous therapy

Abstract

Objective

Patients and methods

Results

Conclusions

Introduction

Section snippets

Patients and methods

Results

Discussion

Acknowledgments

Chest

Pulmonary tuberculosis CT findings-early active disease and sequential change with antituberculous therapy

Radiology

Adult-onset pulmonary tuberculosis: findings on chest radiographs and CT scans

Am J Roentgenol

CT in adults with tuberculosis of the chest Characteristic findings and role in management

Am J Roentgenol

High resolution computed tomographic findings in pulmonary tuberculosis

Thorax