Diagnostic Accuracy of High-Resolution Computed Tomography in Assessing Activity of Pulmonary Tuberculosis

Abstract

Background: High-resolution computed tomography (HRCT) has been used in the diagnosis of Pulmonary TB and rapid TB diagnosis is essential and critical for TB control.

Objective: To evaluate the role of High-Resolution Computed Tomography in diagnosing and assessing the activity of pulmonary tuberculosis in patients.

Methodology: Study Design: Cross-sectional study involving radiographic (HRCT) and clinical analysis of patients with suspected tuberculosis, from October 2018 to March 2019. This study was done on a group of 100 patients with suspected tuberculosis having symptoms of fever, cough with sputum, and hemoptysis. After informed consent first detailed clinical history was taken from patients. Criteria standardized for inclusion was; all age groups and both genders. Patients with a history of previous chest surgery and carcinoma were excluded. Then patients undergoing HRCT chest were analyzed and correlated with clinical findings. Features of primary TB include consolidation, lymphadenopathy, pleural effusion, and miliary nodules whereas post-primary TB include apical consolidation, nodules, and cavitation.

Results: Overall 80 (80%) out of 100 subjects were diagnosed with Pulmonary TB on High-Resolution Computed Tomography (HRCT). The most common HRCT findings were tree in bud appearance (77%), fibrotic changes (72%), consolidation (68%), cavitation (40%), bronchiectatic changes (18%), ground-glass haze (18%), and calcified granulomas( 10%).

Conclusion: Although chest radiography is the foremost imaging technique in the diagnosis and evaluation of pulmonary tuberculosis in our setup, HRCT can be important in early diagnosis and management with greater sensitivity. Bud appearance and consolidation were the commonest patterns found.

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