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How radiology can help pulmonary tuberculosis diagnosis: analysis of 49 patients

  • CHEST RADIOLOGY
  • Published:
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Abstract

Purpose

To identify the most frequent radiological findings of pulmonary tuberculosis using CT of the chest, to determine those with the highest degree of correlation, and, if possible, to identify the most suggestive radiological findings for acid-fast bacilli (AFB) positive disease.

Materials and methods

The radiological and clinical data of 49 patients submitted to CT during diagnosis were retrospectively analysed. The association between findings was assessed using Fisher’s exact test, while correlation at CT scan was evaluated with the Spearman analysis.

Results

Bronchiectasis/bronchioloectasis (89.8%), nodule(s) (81.6%), tree-in-bud (TIB), and consolidation (79.6% each) figured among the most common parenchymal findings. Lymphadenopathy (26.5%) was the most common nodal finding. TIB and cavity showed the highest correlation (r = 0.577), followed by TIB and bronchi(olo)ectasis (r = 0.498), TIB and consolidation (r = 0.497), nodule(s), and ground glass opacity (r = 0.488). High correlation was found in only the seven most frequent parenchymal findings. Consolidation, TIB, and cavity were useful to predict the AFB stain positivity.

Conclusions

Our series confirms the extreme heterogeneity of pulmonary tuberculosis. It also proves there are couple of findings which can drive us to the right diagnosis. While a triad of findings predicts AFB positivity, we have not found any predictive sign of AFB negativity; consequently, all patients with suspected imaging and clinical findings for TB should be isolated.

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Authors and Affiliations

  1. Department of Experimental and Clinical Biomedical Sciences Radiodiagnostic Unit n. 2, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy

    Edoardo Carlesi, Letizia Macconi, Valeria Selvi & Stefano Colagrande

  2. Rheumatology Unit, Department of Experimental and Clinical Medicine, University of Florence, Azienda Ospedaliero-Universitaria Careggi, 50134, Florence, Italy

    Martina Orlandi

  3. Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, 50134, Florence, Italy

    Jessica Mencarini & Alessandro Bartoloni

  4. Infectious and Tropical Diseases Unit, Azienda Ospedaliero-Universitaria Careggi, 50134, Florence, Italy

    Filippo Bartalesi & Alessandro Bartoloni

  5. Department of Health Science, University of Florence, Viale G.B. Morgagni 48, 50134, Florence, Italy

    Chiara Lorini & Guglielmo Bonaccorsi

Authors
  1. Edoardo Carlesi
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  2. Martina Orlandi
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  3. Jessica Mencarini
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  4. Filippo Bartalesi
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  5. Chiara Lorini
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  6. Guglielmo Bonaccorsi
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  7. Letizia Macconi
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  8. Valeria Selvi
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  9. Alessandro Bartoloni
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  10. Stefano Colagrande
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Corresponding author

Correspondence to Stefano Colagrande.

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Conflict of interest

All authors declare that they do not have conflict of interest.

Ethical standards

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. On 28 May 2018, the study obtained the approval of the Local Ethics Committee (protocol #12819).

Informed consent

Informed consent was obtained from all individual participants included in the study. All patients had provided their written informed consent for submission of their chest CT and, if necessary, of an iodinated contrast agent, according to the principles of the Declaration of Helsinki. Patient privacy was maintained (the reviewers knew only the code of the anonymized DICOM files), and patient care was not impacted.

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Carlesi, E., Orlandi, M., Mencarini, J. et al. How radiology can help pulmonary tuberculosis diagnosis: analysis of 49 patients. Radiol med 124, 838–845 (2019). https://doi.org/10.1007/s11547-019-01040-w

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  • DOI: https://doi.org/10.1007/s11547-019-01040-w

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