Computerised tomography scan in multi-drug-resistant versus extensively drug-resistant tuberculosis

Area of Science:

• Radiology
• Infectious Diseases
• Pulmonology

Background:

• Multi-drug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) pose significant global health challenges.
• Distinguishing between MDR-TB and XDR-TB is crucial for appropriate treatment and patient management.

Purpose of the Study:

• To compare computed tomography (CT) scan findings in patients with MDR-TB and XDR-TB.
• To evaluate the diagnostic utility of CT scan features in differentiating these resistant forms of tuberculosis.

Main Methods:

• A comparative descriptive cross-sectional study involving 45 TB patients diagnosed between 2013-2019.
• Patients were categorized into MDR-TB and XDR-TB groups based on drug resistance profiles.
• CT scan findings, including cavitary, parenchymal, and non-parenchymal disorders, were analyzed and compared between groups.

Main Results:

• No significant differences were observed in cavitary lesions (pattern, number, size, lung involvement) between MDR-TB and XDR-TB groups.
• Parenchymal findings like nodules, tree-in-bud opacities, and bronchiectasis showed no significant difference.
• Parenchymal calcification was significantly more prevalent in the XDR-TB group (64.7%) compared to the MDR-TB group (28.6%) (p=0.01).

Conclusions:

• CT scan findings for cavitary, parenchymal, and non-parenchymal lung characteristics are similar between MDR-TB and XDR-TB patients.
• XDR-TB patients demonstrated a tendency towards increased parenchymal calcification and left-sided pleural effusion.
• CT scan features alone are not sufficiently sensitive to reliably differentiate between XDR-TB and MDR-TB.