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Identifying the most infectious lesions in pulmonary tuberculosis by high-resolution multi-detector computed tomography

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective:

This study aimed to determine whether characteristics detected by multi-detector computed tomography (MDCT) were predictive of highly infectious, smear-positive, active pulmonary tuberculosis (PTB).

Methods:

Among 124 patients with active PTB, 84 had positive (group 1) and 40 had negative (group 2) smear results for acid-fast bacilli. Multiplanar MDCT, axial conventional CT and chest X-ray images were analysed retrospectively for morphology, number, and segmental (lobe) distribution of lesions.

Results:

By multivariate analysis, consolidation over any segment of the upper, middle, or lingual lobes, cavitations, and clusters of nodules were associated with group 1, while centrilobular nodules were predictive of group 2. Using five independent variables associated with risk in group 1, a prediction model was created to distinguish between group 1 and group 2. ROC curve analysis showed an area under the curve of 0.951 ± 0.021 for this prediction model. With the ideal cutoff point score of 1, the sensitivity, specificity, and positive predictive values were 84.5%, 97.5%, and 98.0%, respectively.

Conclusions:

A model to predict smear-positive active PTB on the basis of findings from MDCT may be a useful tool for clinical decisions about isolating patients pending sputum smear results.

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Acknowledgments

The authors wish to thank Associate Professor Yi-Hsin Yang, Ph.D., of the Department of Medical Research in Kaohsiung Medical University for her assistance with statistical analysis.

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Authors and Affiliations

  1. Pingtung Christian Hospital, Pingtung, Taiwan

    Jun Jun Yeh, Solomon Chih-Cheng Chen, Wen-Bao Teng, Chun-Hsiung Chou, Shih-Peng Hsieh & Tsung-Lung Lee

  2. Mei-Ho Institute of Technology, Pingtung, Taiwan

    Jun Jun Yeh

  3. China Medical University, Taichung, Taiwan

    Jun Jun Yeh

  4. Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan

    Solomon Chih-Cheng Chen

  5. Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan

    Ming-Ting Wu

  6. Section of Thoracic and Circulation Imaging, Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung, Taiwan, 813, Republic of China

    Ming-Ting Wu

Authors
  1. Jun Jun Yeh
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  2. Solomon Chih-Cheng Chen
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  3. Wen-Bao Teng
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  4. Chun-Hsiung Chou
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  5. Shih-Peng Hsieh
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  6. Tsung-Lung Lee
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  7. Ming-Ting Wu
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Corresponding author

Correspondence to Ming-Ting Wu.

Appendix

Appendix

Table 5 Intra- and inter-observer agreement1
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Yeh, J.J., Chen, S.CC., Teng, WB. et al. Identifying the most infectious lesions in pulmonary tuberculosis by high-resolution multi-detector computed tomography. Eur Radiol 20, 2135–2145 (2010). https://doi.org/10.1007/s00330-010-1796-5

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  • DOI: https://doi.org/10.1007/s00330-010-1796-5

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