UTILITY OF CT IN THE EVALUATION OF PULMONARY TUBERCULOSIS IN PATIENTSWITHOUT AIDS

Objective: To assess the utility of CT in the evaluation of pulmonary tuberculosis in patients without AIDS. Patients and methods: Thin-sect ion CT scans for suspicion of pulmonary tuberculosis were obtained fro m 226 patients. A total of 38 patients were excluded; the reasons were unavailability of final results (n=18), patient unavailability for fo llow-up (n=13), and coexistence of tuberculosis and aspergilloma (n=7) , The results from 188 patients were used for this study, After assess ing the patterns of parenchymal lesion, involved segments, and presenc e of cavity, bronchiectasis, and bronchogenic spread of the lesion wit h CT, tentative diagnosis and disease activity were recorded. Results: With CT, 133 of 146 patients (91%) with tuberculosis were correctly d iagnosed as having pulmonary tuberculosis whereas 32 of 42 patients (7 6%) without tuberculosis were correctly excluded, CT diagnosis of lung cancer (n=8), bacterial pneumonia (n=2), pulmonary metastasis (n=1), chronic hypersensitivity pneumonia (n=1), and diffuse panbronchiolitis (n=1) turned out to be tuberculosis, Conversely CT diagnoses of tuber culosis appeared pathologically as lung cancer (n=5), bacterial pneumo nia (n=4), and pulmonary paragonimiasis (n=1), Active (71/89, 80%) and inactive state (51/57, 89%) of disease respectively could be correctl y differentiated by CT. Conclusion: CT can be helpful in the diagnosis of pulmonary tuberculosis in most cases, On the basis of CT findings, distinction of active from inactive disease can be made in most cases .