Application value of volume CT value inquantifying the activity of pulmonary tuberculosis lesions above 5 mm

doi:10.19982/j.issn.1000-6621.20220104

Abstract

Abstract:

Objective: To explore the auxiliary diagnostic value of volume CT value in quantifying the activity of pulmonary tuberculosis. Methods: A total of 224 patients with clinically confirmed pulmonary tuberculosis from January 2013 to May 2017 in the Department of Tuberculosis, Hangzhou Chest Hospital, Medical College of Zhejiang University were selected.And 216 active tuberculosis lesions and 128 inactive tuberculosis lesions were included according to the standard of that the shortest diameter line on the mediastinal window >5 mm.ITK-SNAP software was used to manually segment lesion images, calculate CT values of lesion volume, and analysis the ROC curve.Based on the final clinical diagnosis, the auxiliary diagnostic efficacy and consistency of the conventional CT reading method and the volume CT values in determining the activity of pulmonary tuberculosis were compared. Results: The volume CT value of 216 active pulmonary tuberculosis lesions was significantly lower than that of 128 inactive pulmonary tuberculosis lesions (32.38 (28.17, 36.23) HU vs. 78.89 (57.78, 120.27) HU, Z=-15.439, P<0.001). ROC curve analysis showed that, when the maximum value of Youden index was 0.958, the best critical value was 45.79 HU, the sensitivity and specificity of volume CT value in judging active pulmonary tuberculosis were 96.3% and 100.0%, with a maximum area under the AUC curve of 0.998. Taking the final clinical diagnosis as the reference standard, the sensitivity, specificity, accuracy and Kappa value of the conventional CT reading method to determine the activity of pulmonary tuberculosis were 71.8%(155/216), 71.1%(91/128), 71.5% (246/344)and 0.413, respectively; while those of volume CT value were 96.3%(208/216), 100.0%(128/128), 97.7%(336/344) and 0.951, respectively. Conclusion: By measuring the volume of pulmonary tuberculosis lesions, CT value can accurately quantify the activity of pulmonary tuberculosis, which is of very important auxiliary diagnostic value.

Key words: Tuberculosis,pulmonary, Tomography scanners,X-ray computed, Radiometry, Diagnostic imaging

CLC Number:

R521
R445.3

Wei Ganhui, Zhang Jiacheng, Qiu Xiaowei. Application value of volume CT value inquantifying the activity of pulmonary tuberculosis lesions above 5 mm[J]. Chinese Journal of Antituberculosis, 2022, 44(9): 934-939. doi: 10.19982/j.issn.1000-6621.20220104

Figures/Tables 3

References 13

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方法	确诊结核病灶(个)		敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	一致率 (%)	Kappa值
方法	活动性	非活动性	敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	一致率 (%)	Kappa值
常规阅片法			71.8	71.1	80.7	59.9	71.5	0.413
活动性	155	37
非活动性	61	91
容积CT值			96.3	100.0	100.0	94.1	97.7	0.951
活动性	208	0
非活动性	8	128

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