CT features of residual inactive tuberculosis lesions in cured patients of pulmonary tuberculosis

doi:10.19982/j.issn.1000-6621.20210734

Abstract

Abstract:

Objective: To investigate the distribution, CT characterization and evolution of stable inactive tuberculosis lesions in cured patients without medical intervention for a long time. Methods: A retrospective cohort study of 100 patients who met the inclusion criteria from May 2017 to July 2020 at Beijing Chest Hospital, Capital Medical University was conducted. The distribution, CT-morphological characterization, and evolutionary features of inactive intrapulmonary lesions were summarized and analyzed from two groups of follow-up data. Results: The most common signs of inactive intrapulmonary lesions in 100 cured patients were fibrous stripes (88.0%), nodules (67.0%), and patchy opacity (63.0%). 6.5 (1.0,8.3) of nodular lesions and 1.6 (1.0,2.0) of patchy lesions were detected per capita. Nodules, patchy opacity, and strips opacity with visible calcification, pleural adhesions, and poorly defined edges of fibrous stripes on the margins were 92.6% (403/435), 52.9% (54/102) and 81.0% (17/21), 72.2% (314/435), 93.1% (95/102) and 100.0% (21/21), 76.6% (333/435), 96.1% (98/102) and 100.0% (21/21), respectively. Compared with the result of pre- and post-follow-up examination, nodules, patchy opacity, and strips opacity were significantly reduced (Z=-10.289, P<0.001; Z=-3.658, P<0.001; Z=-2.312, P=0.021; Z=-7.524, P<0.001; Z=-3.334, P=0.001; Z=-2.194, P=0.028) in cross-sectional maximum diameter (6.97 (5.44, 10.47) mm and 6.72 (4.87, 9.67) mm, 18.30 (10.67, 30.46) mm and 16.00 (9.59, 30.76) mm, 42.30 (21.63, 74.90) mm and 41.75 (18.75, 73.37) mm), and lesion volume (18.03 (14.86, 77.89) mm³ and 16.10 (14.02, 55.04) mm³, 201.57 (61.02, 633.55) mm³ and 144.29 (58.68, 612.75) mm³, 3224.00 (410.50, 5265.00) mm³ and 3138.25 (302.08, 3865.50) mm³). In the contrary, the mean CT values in nodules and patchy opacity (157.01 (126.24, 236.77) HU and 211.22 (144.96, 342.05) HU, 19.79 (17.22, 45.89) HU and 31.15 (16.16, 64.08) HU) were significantly increased (Z=-10.342, P<0.001; Z=-4.094, P<0.001). Conclusion: The most common signs of inactive intrapulmonary lesions in cured patients with pulmonary tuberculosis were fibrous stripes, nodules, and patchy opacity, and most of them presented as calcification, pleural adhesions, and poorly defined edges of fibrous stripes. Two follow-up data suggested a reduction in volume and elevation in density of incomplete calcification and fibrous lesions, and this finding was significant for determining the activity of pulmonary tuberculosis lesions.

Key words: Tuberculosis,pulmonary, Prognosis, Tomography,X-ray computed

CLC Number:

R521
R81

QIN Li-yi, LYU Yan, YANG Yang, JIA Jun-nan, HUO Feng-min, LI Wei-min, LYU Ping-xin. CT features of residual inactive tuberculosis lesions in cured patients of pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2022, 44(4): 336-342. doi: 10.19982/j.issn.1000-6621.20210734

Figures/Tables 4

References 30

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CT征象分类	检出病灶[个 (检出率,%)]	检出患者[例 (检出率,%)]	人均检出病灶 [个,M(Q₁,Q₃)]
确定的非活动性病变(150处)
索条	87(58.0)	88(88.0)	1.0(-)
支气管扩张征	27(18.0)	27(27.0)	1.0(-)
肺气肿	17(11.3)	16(16.0)	1.0(-)
间质受累	15(10.0)	14(14.0)	1.0(-)
肺不张	2(1.3)	2(2.0)	1.0(-)
分支管状影	2(1.3)	2(2.0)	1.0(-)
活动性不确定病变(560处)
结节影	435(77.7)	67(67.0)	6.5(1.0,8.3)
斑片影	102(18.2)	63(63.0)	1.6(1.0,2.0)
条片影	21(3.8)	18(18.0)	1.0(-)
空洞	2(0.3)	2(2.0)	1.0(-)

CT表现	检出个数	钙化病灶 [个(发生率,%)]	与胸膜粘连 [个(发生率,%)]	病灶边缘索条 [个(发生率,%)]
结节影	435	403(92.6)	314(72.2)	333(76.6)
斑片影	102	54(52.9)	95(93.1)	98(96.1)
条片影	21	17(81.0)	21(100.0)	21(100.0)
空洞	2	-	-	-

CT征象	横断最大径[mm,M(Q₁,Q₃)]	体积[mm³,M(Q₁,Q₃)]	CT均值[HU,M(Q₁,Q₃)]
结节影
T1	6.97(5.44,10.47)	18.03(14.86,77.89)	157.01(126.24,236.77)
T2	6.72(4.87,9.67)	16.10(14.02,55.04)	211.22(144.96,342.05)
△T	0.30(0.05,0.57)	1.04(0.00,9.05)	-40.38(-92.76,-13.71)
△T/T1(%)	-	5.42(0.00,13.32)	-
Z值	-10.289	-7.524	-10.342
P值	<0.001	<0.001	<0.001
斑片影
T1	18.30(10.67,30.46)	201.57(61.02,633.55)	19.79(17.22,45.89)
T2	16.00(9.59,30.76)	144.29(58.68,612.75)	31.15(16.16,64.08)
△T	0.33(-0.10,1.75)	30.10(0.00,57.29)	-5.93(-14.89,0.64)
△T/T1(%)	-	12.75(0.00,23.40)	-
Z值	-3.658	-3.334	-4.094
P值	<0.001	0.001	<0.001
条片影
T1	42.30(21.63,74.90)	3224.00(410.50,5265.00)	32.91(18.23,50.88)
T2	41.75(18.75,73.37)	3138.25(302.08,3865.50)	33.06(18.77,58.41)
△T	1.32(0.14,1.90)	221.15(-5.18,1222.63)	0.03(-6.68,3.06)
△T/T1(%)	-	22.68(-1.19,33.06)	-
Z值	-2.312	-2.194	-0.534
P值	0.021	0.028	0.594