Computed Tomography Thorax- Role in the Diagnosis of Pulmonary Tuberculosis

Abstract

BACKGROUND Tuberculosis is one of the leading causes of mortality in a developing country like India among the infectious diseases. Early diagnosis of tuberculosis is by chest X-Ray, sputum examination, culture and nucleic acid amplification. Chest X-Ray findings are not very specific, sputum examination and culture take many days thus delaying the diagnosis. CT scan is very fast, non-invasive and accurate. It can diagnose the cause of unexplained cough, chest pain, fever and other chest symptoms. Because of accuracy, high speed and better resolution, CT scan is the modality of choice for early detection of pulmonary TB. The aim of the study is to evaluate the role of CT and HRCT in pulmonary TB. METHODS It is a cross sectional study conducted at Jawaharlal Nehru Institute of Medical Sciences from January 2016 to June 2016 in a series of cases sent for CT or HRCT using AQUILION, Toshiba 64 slice multi detector CT. All the data were entered in excel sheet and transferred to SPSS Version 2 and then analysed by using descriptive statistics like mean, standard deviation and percentage. Chi square test was used. p Value of <0.05 was taken as statistically significant. RESULTS Among 358 cases, 49.7% (178 cases) were diagnosed as pulmonary tuberculosis. In cases diagnosed as pulmonary TB, 104 (58.4%) were male and 74 (41.7%) were female. Over 60 yrs. of age, 56.1% of the cases had TB with cavitary and parenchymal lesion, followed by TB with lung destruction & cicatrisation in 17.3% of the cases. In younger age group, 20 years and below, had TB with cavitary & parenchymal lesions in 75% of cases and TB with chronic empyema & fibrothorax in 25% cases. Incidence of TB in higher age groups was statistically significant (p<0.05). CONCLUSIONS CT and HRCT can diagnose different stages of pulmonary TB and any associated diseases. It helps in taking treatment decisions and preventing disease spread which is an important health issue. For early detection of pulmonary TB, CT and HRCT is a must for diagnosis.