ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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vol. 85
Chest radiology
Original paper

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

Payam Mehrian
Poopak Farnia
2, 3
Dina Jalalvand
Mostafa Rezaei Chamani
Mahmood Bakhtiyari

Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mycobacteriology Research Centre (MRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
© Pol J Radiol 2020; 85: e39-e44
Online publish date: 2020/01/23
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Multi-drug-resistant tuberculosis (MDR-TB) is simultaneously resistant to isoniazid and rifampin. Of course, this germ may also be resistant to other anti-tuberculosis drugs. Patients with extensively drug-resistant tuberculosis (XDR-TB) are also resistant to all types of fluoroquinolone and at least one of the three injectable medications: amikacin, clarithromycin, or kanamycin, in addition to isoniazid and rifampin. Therefore, the main objective of the current study was to evaluate and compare the computed tomography (CT) scan findings of MDR-TB and XDR-TB patients.

Material and methods
In this comparative descriptive cross-sectional study 45 consecutive TB patients who referred to Masih Daneshvari Hospital, Tehran, Iran from 2013 to 2019 were enrolled. TB was diagnosed based on sputum smear and sensitive molecular and microbial tests. Patients were divided into two groups (MDR-TB and XDR-TB) based on two types of drug resistance. CT scan findings were compared for cavitary, parenchymal, and non-parenchymal disorders. The early diagnostic values of these factors were also calculated.

Findings related to cavitary lesions including the pattern, number, size of the largest cavity, maximum thickness of the cavity, lung involvement, number of lobes involved, and the air-fluid levels in the two patient groups were similar (p > 0.05). Parenchymal findings of the lung also included fewer and more nodules of 10 mm in the MDR-TB and XDR-TB groups, respectively. Tree-in-bud, ground-glass-opacity, bronchiectasis, cicatricial emphysema, and lobar atelectasis were similar in the two patient groups (p > 0.05). Findings outside the parenchymal lung, including mediastinal lymphadenopathy and pericardial effusion, showed no statistically significant difference between the MDR-TB and XDR-TB groups (p > 0.05). Parenchymal calcification was more common in the XDR group than in the MDR group (64.7% and 28.6%, respectively) with a significant difference (p = 0.01).

CT scan findings in patients with XDR-TB are similar to those of patients with MDR-TB for cavitary, parenchymal, and non-parenchymal lung characteristics. However, patients with XDR-TB tend to have more parenchymal calcification and left-sided plural effusion. CT characteristics overlap between XDR-TB and those with MDR-TB. It can be concluded that CT scan features are not sensitive to the diagnosis.


tuberculosis, antimicrobial resistance, computerised tomography scan

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