High resolution chest CT in tuberculosis: evolutive patterns and signs of activity

The purpose of our study was to determine evolutive patterns and signs of active tuberculosis on high resolution CT (HRCT) scans.

We followed up over 15 months 27 patients with postprimary pulmonary tuberculosis that was proven bacteriologically. CT scans were performed before, during, and after 6 months of anti-tuberculosis treatment. Both 10-mm-thick sections and 1.5-mm-thick HRCT scans were performed.

Ground-glass pattern was noticed 26 times, 9 times after 2 month treatment and only 2 times after 6 month treatment. Among these two patients, one did not undergo his treatment properly and the other one had an additional bacterial infection. Centrilobular nodules (n = 17) and poorly marginated nodules (n = 21) were present only before treatment. Reticular pattern (intralobular and septal thickening), interstitial nodules, and fibrosis were seen both before and after treatment. Ground-glass pattern, poorly marginated nodules, and infiltrates as well as centrilobular nodules were related to an active infection.

This HRCT may be helpful to demonstrate activity in patients suspected of having tuberculosis and to assess antituberculous treatment efficiency.