Y H Wang1, A S Lin, Y F Lai, T Y Chao, J W Liu, S F Ko. 1. Division of Pulmonary Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan, Republic of China. yihsi@ksts.seed.net.tw
Abstract
SETTING: A 2500-bed medical centre in southern Taiwan. OBJECTIVE: To study the clinical value of high-resolution computed tomography (HRCT) in predicting the activity of pulmonary tuberculosis (TB). DESIGN: HRCTs were performed prospectively in 148 patients whose chest radiographs (CXRs) showed highly suspicious signs of pulmonary TB, predominantly upper lung field infiltration. The HRCT findings, interpreted independently by a pulmonologist and a radiologist, were used to predict the activity of pulmonary TB. RESULTS: Pulmonologist-interpreted and radiologist-interpreted HRCTs showed high sensitivity (both 93%), specificity (83 vs. 88%), accuracy (86 vs. 90%), positive predictive values (76 vs. 83%) and negative predictive values (both 95%). Kappa statistic indicates good inter-reader agreement. CONCLUSION: HRCT has a high value in predicting the activity of pulmonary TB. It is a useful tool in this regard when a patient with suspected pulmonary TB lacks microbiologic proof, when clinical condition makes invasive diagnosis impossible or when a patient has completed anti-tuberculosis treatment with no compatible unequivocal CXR.
SETTING: A 2500-bed medical centre in southern Taiwan. OBJECTIVE: To study the clinical value of high-resolution computed tomography (HRCT) in predicting the activity of pulmonary tuberculosis (TB). DESIGN: HRCTs were performed prospectively in 148 patients whose chest radiographs (CXRs) showed highly suspicious signs of pulmonary TB, predominantly upper lung field infiltration. The HRCT findings, interpreted independently by a pulmonologist and a radiologist, were used to predict the activity of pulmonary TB. RESULTS: Pulmonologist-interpreted and radiologist-interpreted HRCTs showed high sensitivity (both 93%), specificity (83 vs. 88%), accuracy (86 vs. 90%), positive predictive values (76 vs. 83%) and negative predictive values (both 95%). Kappa statistic indicates good inter-reader agreement. CONCLUSION: HRCT has a high value in predicting the activity of pulmonary TB. It is a useful tool in this regard when a patient with suspected pulmonary TB lacks microbiologic proof, when clinical condition makes invasive diagnosis impossible or when a patient has completed anti-tuberculosis treatment with no compatible unequivocal CXR.
Authors: Ray Y Chen; Lori E Dodd; Myungsun Lee; Praveen Paripati; Dima A Hammoud; James M Mountz; Doosoo Jeon; Nadeem Zia; Homeira Zahiri; M Teresa Coleman; Matthew W Carroll; Jong Doo Lee; Yeon Joo Jeong; Peter Herscovitch; Saher Lahouar; Michael Tartakovsky; Alexander Rosenthal; Sandeep Somaiyya; Soyoung Lee; Lisa C Goldfeder; Ying Cai; Laura E Via; Seung-Kyu Park; Sang-Nae Cho; Clifton E Barry Journal: Sci Transl Med Date: 2014-12-03 Impact factor: 17.956
Authors: Yousang Ko; Ho Young Lee; Yong Bum Park; Su Jin Hong; Jeong Hwan Shin; Seok Jin Choi; Changhwan Kim; So Young Park; Jin Young Jeong Journal: PLoS One Date: 2018-08-09 Impact factor: 3.240