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[High resolution computerized tomography in pulmonary tuberculosis with negative sputum bacilloscopy].

E González Constán1, J Franco Serrano, M L Domingo Montañana

  • 1Servicios de Neumología. Hospital Universitario Dr. Peset. Valencia. Spain. edgonc@ono.com

Revista Clinica Espanola
|November 6, 2003
PubMed
Summary

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High-resolution computed tomography (HRCT) aids in diagnosing pulmonary tuberculosis when sputum tests are negative. Findings like consolidation and nodules on HRCT effectively indicate active disease.

Area of Science:

  • Radiology
  • Pulmonology
  • Infectious Diseases

Background:

  • Pulmonary tuberculosis diagnosis is challenging with negative sputum bacilloscopy, especially without liquid culture media.
  • Slow Mycobacterium tuberculosis growth and invasive procedures complicate traditional diagnostic methods.

Purpose of the Study:

  • To evaluate high-resolution computed tomography (HRCT) findings in pulmonary tuberculosis patients with negative sputum bacilloscopy.
  • To determine the diagnostic utility of specific HRCT features for active and inactive pulmonary tuberculosis.

Main Methods:

  • Prospective evaluation of 28 patients (12 active, 16 inactive tuberculosis) using HRCT.
  • Assessment of various HRCT findings including nodules, consolidation, cavitation, bronchiectases, and fibrotic changes.

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Main Results:

  • Consolidation, macronodules, and centrolobular nodules were significantly associated with active tuberculosis (67% each).
  • Centrolobular nodules and/or consolidation showed 83% sensitivity and 87% specificity for active disease.
  • Bronchiectases (87%) and broncovascular distortion (62%) were significantly associated with inactive tuberculosis.

Conclusions:

  • HRCT is valuable for diagnosing pulmonary tuberculosis with negative sputum bacilloscopy.
  • The presence of centrolobular nodules and/or consolidation on HRCT is a sensitive and specific indicator of active pulmonary disease.