Computed tomography features of lung parenchymal changes in pulmonary tuberculosis

Area of Science:

• Radiology
• Pulmonology
• Infectious Diseases

Background:

• Pulmonary tuberculosis (TB) is a significant global health concern.
• Accurate and timely diagnosis is crucial for effective treatment and control.
• Computed tomography (CT) offers detailed visualization of lung parenchyma.

Purpose of the Study:

• To prospectively evaluate the CT findings in patients with active pulmonary tuberculosis.
• To identify and characterize major parenchymal patterns associated with pulmonary TB.
• To correlate CT features with bronchogenic spread and other complications.

Main Methods:

• Prospective study of 25 patients diagnosed with active pulmonary tuberculosis.
• Detailed analysis of chest CT scans, including high-resolution CT (HRCT) where applicable.
• Categorization of parenchymal patterns and assessment of associated features like cavitation and bronchiectasis.

Main Results:

• Nodular opacities were present in all cases.
• Consolidation with associated loss of volume (CWALV) was observed in 69% of patients.
• High-resolution CT (HRCT) demonstrated features of bronchogenic spread, including centrilobular nodules (92.3%), 'tree in bud' appearance (92.3%), bronchial wall thickening (61.5%), and poorly marginated nodules (61.5%).
• Cavitation was most frequent in CWALV lesions.
• Bronchiectasis (81.3%) and pleural thickening (50%) were common associated findings.

Conclusions:

• CT demonstrates distinctive parenchymal patterns in pulmonary tuberculosis.
• The identified CT features, such as nodular opacities, CWALV, and signs of bronchogenic spread, are suggestive of pulmonary TB in appropriate clinical settings.
• CT plays a vital role in the radiological diagnosis and assessment of complications in pulmonary tuberculosis.