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Jain, A., Malhotra, A., Arora, D., Maqusood, M., & Kumar, S. (2021). Assessment of Disease Activity and Complications in Patients of Pulmonary Tuberculosis by High Resolution Computed Tomography. Sudan Journal of Medical Sciences (SJMS), 16(2), 159–177. https://doi.org/10.18502/sjms.v16i2.9286

https://doi.org/10.18502/sjms.v16i2.9286

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authors

  • Ashwani Jain

    Ashwani Jain

    Resident, Department of Radiodiagnosis, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh- 244001, India.
  • Ankur Malhotra

    Ankur Malhotra

    Associate Professor, Department of Radiodiagnosis, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh- 244001, India.
  • Deepti Arora

    Deepti Arora

    Associate Professor, Department of Pathology, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh- 244001, India.
  • Mazher Maqusood

    Mazher Maqusood

    Professor, Department of Pulmonary Medicine, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh- 244001, India.
  • Sunil Kumar

    Sunil Kumar

    Professor, Department of Radiodiagnosis, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh- 244001, India.

Published Date

  • Jun 30, 2021

Assessment of Disease Activity and Complications in Patients of Pulmonary Tuberculosis by High Resolution Computed Tomography

Sudan Journal of Medical Sciences (SJMS) / Sudan JMS: Volume 16 (2021), Issue No. 2 / Pages 159–177

Abstract

Background: Tuberculosis (TB) is a global health problem and the second most common infectious cause of death. High-resolution computed tomography (HRCT) is far more superior to chest radiography as well as conventional CT for analyzing the pulmonary parenchyma. This study aimed to evaluate the role of HRCT in pulmonary tuberculosis (PTB) with respect to disease activity and complication after anti-tubercular therapy (ATT).


Methods: This prospective observational study was conducted in the Department of Radiodiagnosis, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC) for a period of 1.5 years. A total of 50 cases of newly diagnosed TB were included in the study and a standard six-month ATT was given to the patients. Pulmonary involvement was evaluated by HRCT (128 slice multi-detector PHILIPS INGENUITY CT scanner), twice for each patient (first scan after diagnosis and second after treatment completion). The acquired HRCT images were reconstructed on a highresolution lung algorithm and parenchymal, bronchial, and extra parenchymal findings were recorded systematically.


Results: Out of the 50 patients, 5 died within two months of the initiation of treatment and four were lost to follow-up. Thus, post treatment follow-up sample size was reduced to 41 patients. Ill-defined nodules (96%), tree-in-bud pattern (74%), consolidation (86%), cavitary lesions (98%), and ground glass opacities (58%) were the main imaging features of active cases of TB on HRCT. Resolution to thin-walled cavitary lesions (36.5%), bronchiectasis (41.5%), and fibrotic (parenchymal) bands (66%) were common complications or sequelae which were observed after completion of treatment.


Conclusion: HRCT thorax is a sensitive modality for evaluation of parenchymal and airway manifestations in cases of PTB and can aid in differentiation of active disease from healed disease. It allows early identification of post-treatment complications and sequelae in patients of PTB.

Keywords:

HRCT, lung, tuberculosis, pulmonary, complications

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