Determination of the Activity of Pulmonary Tuberculosis: the Utility of High-Resolution Computed Tomography

Objective: To determine role of endobronchial washings/biopsy in diagnosis of smear negative pulmonary tuberculosis and evaluate their association with computed tomography findings. Study Design: Cross-sectional - analytical study. Place and Duration of Study: Department of Pulmonology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2020. Methodology: Patients having symptoms of pulmonary tuberculosis and abnormal findings on chest imaging with negative sputum smears for acid fast bacilli were selected for endobronchial washings. Bronchoscopy for washings was carried out in these patients and sample was sent for Acid fast bacilli stain, Mycobacterium tuberculosis gene Xpert and acid fast bacilli culture and sensitivity bacterial culture and fungal hyphae. In case of mass lung endobronchial and/or transbronchial lung biopsy was done and sample was sent for histopathology Active pulmonary tuberculosis was labelled as per definition. Results: Out of 105, 75 (71.4%) were male and 30 (28.6%) were female. Mean age was 55.69 ± 17.33 years. Total 40 (38.09%) were diagnosed with pulmonary tuberculosis (based on smear, genexpert, culture and histopathology). In these 40 patients, computed tomographic findings showed consolidation in 10 (25%) cases, cavity in 7 (17.5%), bronchiectasis in 3 (7.5%), mass in 1 (2.5%), pleural effusion in 2 (5%), lymphadenopathy in 1 (2.5%) and tree-in-budappearance in 12 (30%) cases. Conclusion: High resolution computed tomography and endobronchial washing both combined together increase the diagnostic yield in smear negative cases.

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The Predictive Value of Multidetector High Resolution Computed Tomography in Evaluation of Suspected Sputum Smear Negative Active Pulmonary Tuberculosis in Egyptian Zagazig University Hospital Patients

Polish Journal of Radiology ◽

10.12659/pjr.903743 ◽

2017 ◽

Vol 82 ◽

pp. 808-816

Author(s):

Ahmed Mohamed Alsowey ◽

Mohamed Ibrahim Amin ◽

Ahmed Mohamed Said

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Pulmonary Tuberculosis ◽

Predictive Value ◽

University Hospital ◽

Sputum Smear ◽

High Resolution Computed Tomography ◽

Active Pulmonary Tuberculosis ◽

Hospital Patients ◽

Smear Negative

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Changes in the Selected Antioxidant Defense Parameters in the Blood of Patients after High Resolution Computed Tomography

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091476 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1476 ◽

Cited By ~ 3

Author(s):

Amira Bryll ◽

Wirginia Krzyściak ◽

Anna Jurczak ◽

Robert Chrzan ◽

Anna Lizoń ◽

...

Keyword(s):

Oxidative Stress ◽

Computed Tomography ◽

High Resolution ◽

Ionizing Radiation ◽

Antioxidant Defense ◽

Antioxidant Systems ◽

High Resolution Computed Tomography ◽

Time Points ◽

Antioxidant Markers

Ionizing radiation generated during high resolution computed tomography (HRCT) scanning may have an indirect effect on the mechanisms regulating the oxidative-antioxidant balance in the human body, which is one of the necessary factors ensuring the maintenance of its homeostasis. The aim of the study was to analyze the response of antioxidant systems through the determination of the antioxidant markers in the blood of patients exposed to oxidative stress resulting from the routine HRCT examination of the chest. Blood of 35 people aged 60.77 ± 10.81 taken before and at four time points after the examination constituted the test material. The determination of the total antioxidant capacity expressed as ferric reducing ability of plasma (FRAP) and ferric reducing antioxidant activity and ascorbic acid concentration (FRASC) were performed together with an examination of catalase activity and the concentration of the reduced glutathione. The organism’s response to ionizing radiation was associated with a significant decrease in the antioxidant markers’ levels at all time-points and showed a significant negative correlation depending on the radiation dose. Visible down-regulation of these markers is a response to increased oxidative stress. In light of the obtained results, the measurement of the selected markers of antioxidant defense may be a useful parameter of oxidative stress caused by ionizing radiation.

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

Sudan Journal of Medical Sciences ◽

10.18502/sjms.v16i2.9286 ◽

2021 ◽

Author(s):

Ashwani Jain ◽

Ankur Malhotra ◽

Deepti Arora ◽

Mazher Maqusood ◽

Sunil Kumar

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Pulmonary Tuberculosis ◽

Disease Activity ◽

Post Treatment ◽

Research Centre ◽

Imaging Features ◽

Ct Scanner ◽

High Resolution Computed Tomography

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.

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