Abstract:

Objective To investigate the CT findings in patients with initial and retreated multidrug-resistant tuberculosis. Methods A total of 186 patients with multidrug-resistant tuberculosis diagnosed by drug susceptibility testing in Chongqing Public Health Medical Treatment Center from January 2016 to January 2019 were collected, including 80 newly treated patients as initial treatment group and 106 retreated patients as retreatment group. The lesion size, lesion morphology (tree in bud, acinar node, speckle shadow, large shadow, strip shadow, calcification shadow), the number and shape of cavity, the shape of cavity wall, bronchiectasis and other CT findings were compared between the two groups. The CT findings were statistically analyzed by χ ² test, and the difference was statistically significant (P<0.05). Results In the retreatment group (106 cases), there were destroyed lungs in 22 cases (20.8%,22/106), lesion size more than 3 lobes in 96 cases (90.6%,96/106), lesions located in the middle lobe and tongue segment in 91 cases (85.8%, 91/106), strip shadow in 58 cases (54.7%,58/106), calcification shadow in 29 cases (27.4%,29/106) and bronchiectasis in 82 cases (77.4%, 82/106), respectively, when compared for those (6.2% (5/106), 71.2% (57/80), 72.5% (58/80), 23.8% (19/80), 10.0% (8/80), 31.2% (25/80)) in initial group with the significant differences statistically (χ ² values were 7.730, 11.656, 5.098, 18.021, 8.621, 39.670, Ps<0.05). In the retreatment group (106 cases), Chest collapse occurred in 23 cases (21.7%, 23/106), mediastinal displacement in 38 cases (35.8%,38/106), pleural thickening in 83 cases (78.3%,83/106), when compared for those (5.0% (4/80), 7.5% (6/80), 53.8% (43/80)) in the initial treatment group with the significant difference statistically (χ ² values were 8.943, 20.288, 12.576, Ps<0.05). The incidence of cavity was 83.0% (88/106), the number of cavity more three in 63 cases (59.4%,63/106), thicken-wall cavity in 75 cases (70.8%, 75/106), thin-wall cavity in 43 cases (40.6%,43/106), moth-eaten cavity in 43 cases (40.6%,43/106), cluster cavity in 43 cases (40.6%,43/106) and cavity with rough inner wall in 22 cases (20.8%,22/106), when compared for those (56.2% (45/80),23.8% (19/80),51.2% (41/80),12.5% (10/80),16.2% (13/80),16.2% (13/80) and 7.5% (6/80)) in initial group with the significant difference statistically (χ ² value were 16.034,23.551,7.390,17.626,12.810,12.810 and 6.264, Ps<0.05). Conclusion The CT findings of retreated MDR-TB patients are more serious than those of the initial treatment group, such as wide lesion, destroyed lungs, multiple cavities and cluster aggregation, caseous pneumonia with moth-eaten cavity and varicose bronchiectasis.

Key words: Tuberculosis,multidrug-resistant, Retreatment, Tomography,X-Ray computed, Diagnosis-related groups, Diagnostic imaging, Comparative study