ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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vol. 83
Original paper

The predictive value of multidetector high resolution computed tomography in evaluation of suspected sputum smear negative active pulmonary tuberculosis in Egyptian Zagazig University Hospitals patients

Ahmed Mohamed Alsowey, Mohamed Ibrahim Amin, Ahmed Mohamed Said

© Pol J Radiol 2018; 83: e24-e31
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Purpose: The aim of this work is to study the usage of multi-detector high-resolution computed tomography (HRCT) chest in diagnosing pulmonary tuberculosis (PTB) cases whose sputum smears are negative and making a correlation between their computed tomography (CT) features and their sputum culture results.

Material and methods: This study was car ried out from December 2014 to December 2016 at Zagazig University Hospitals, Radiodiagnosis Department. It included 150 patients. Their ages ranged between 10 to 70 years with a mean age 40 years. They were referred from the outpatient respiratory medicine clinic of the hospital. All patients had been presented clinically with suspicion of PTB. Their clinical features and HRCT findings were investigated to predict the risk for PTB. We then designed provisional HRCT diagnostic criteria based on the results to rank the risk of PTB.

Results: A positive tuberculin skin test alone among clinical laboratory findings was significantly associated with an increase of risk of PTB. Centrilobular nodules, large nodules, tree-in-bud appearance and the main lesion being located in S1, S2, and S6 lung segments were significantly associated with an increased risk of PTB. At HRCT 40 out of 44 patients with class III ranking showed active PTB. Twelve out of 51 patients presented with class II ranking and 8 out of 40 were ranked as class I. The sensitivity, specificity and positive likelihood ratio of class I ranking HRCT criteria to diagnose active PTB were 95%, 40% and 1.4, respectively. Class II ranking results were 85%, 72%, 3, respectively. Finally class III ranking results were 45%, 90%, 11.5, respectively.

Conclusions: Cases suspected of having active PTB whose smears are negative can benefit from multi-detector high-resolution computed tomography (MD-HRCT) chest findings to predict those patients of high risk with good reproducibility.

multidetector computed tomography, pulmonary tuberculosis, sputum culture

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