Abstract
Background: Rapid diagnosis of pulmonary tuberculosis (PTB) is critical for TB control. High-resolution computed tomography (HRCT) has been used in the diagnosis of PTB.
Aims and objectives: We investigated the utility of HRCT for the rapid diagnosis of sputum smear and polymerase chain reaction (PCR)-negative PTB.
Methods: We reviewed the medical records of sputum smear and PCR-negative PTB suspects who checked HRCT from January 2011 to December 2014 in a tertiary hospital of South Korea. Final diagnosis of PTB was made based on culture, bronchoscopy, biopsy and appropriate response to treatment. We assessed the diagnostic accuracy of HRCT in the diagnosis of PTB. We also assessed HRCT findings associated with PTB,
Results: Of 113 sputum smear and PCR negative PTB suspects who checked HRCT, 45 (39.8%) were finally diagnosed to have PTB. Among 46 (40.7%) patients who were suggested to have PTB based on HRCT, 36 (78.3%) were finally diagnosed to have PTB and 10 (21.7%) were finally diagnosed not to have PTB (6 pneumonia, 3 bronchiectasis, 1 nontuberculous mycobacterial lung disease). Among 67 patients suggested not to have PTB based on HRCT, 9 (13.4%) were finally diagnosed to have PTB. The sensitivity and specificity, positive predictive and negative predictive value of HRCT for the diagnosis of PTB were 80.0%, 85.3%, 78.3%, 86.6%, respectively. Among the radiologic characteristics of HRCT, the presence of tree-in-bud appearance was significantly associated with PTB (p=0.02).
Conclusions: HRCT is useful for the rapid diagnosis of PTB in sputum smear and PCR-negative PTB suspects. The presence of tree-in-bud appearance was the most characteristic HRCT finding of PTB.
- Copyright ©the authors 2016