How to Differentiate Inactive from Active Disease in Patients of Primary Multidrug-resistant Tuberculosis with Persistent Cavity after Anti-tuberculous Therapy

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SH Kim, JH Min, JY Lee

Hong Kong J Radiol 2014;17:240-6

DOI: 10.12809/hkjr1413228

Objective: To determine how to differentiate inactive from active disease in patients with primary multidrug-resistant tuberculosis who have a persistent cavity after completing treatment.

Methods: We evaluated computed tomography findings to determine activity of chronic cavitary disease in patients with primary multidrug-resistant tuberculosis after completing treatment. This study evaluated cavity, centrilobular nodules, consolidation, large nodules, calcified nodules, parenchymal calcification, emphysema, bronchovascular distortion, irregular lines, and parenchymal band. The presence of pleural thickening, pleural effusion, and lymphadenopathy was recorded.

Results: In univariate analysis, centrilobular nodules and consolidation were significantly less common in the chronic inactive cavitary group. The cavity wall was thinner in the chronic inactive cavitary group than that in the chronic active cavitary group. A multivariate analysis revealed that centrilobular nodules and thickness of the cavity wall were significant computed tomography findings associated with active disease.

Conclusions: Centrilobular nodules and thickness of the cavity wall were the most characteristic computed tomography findings to predict active disease in patients with chronic cavitary pulmonary multidrug-resistant tuberculosis at the time of treatment completion. In the proper clinical setting, these computed tomography findings could help decision-making for completing treatment in cases of chronic cavitary multidrug-resistant tuberculosis after anti-tuberculous therapy.




金尚泫、JH Min、JY Lee