Effectiveness of radiologic examination methods in diagnosis of pulmonary tuberculosis

Abstract

OBJECTIVE OF THE STUDY: To determine an optimal noninvasive radiologic examination method (computed tomography or roentgenography) in early diagnostics of pulmonary tuberculosis. MATERIALS AND METHODS: We have selected 43 patients with diagnosis of pulmonary tuberculosis, who were examined using roentgenography and computed tomography during 2002-2006. Data were confirmed by biopsy or bacteriological test. Evaluation criteria were anamnesis, prolonged cough productive of sputum, prolonged fever, roentgenologic and laboratory findings (lymphocytosis, monocytosis), antibiotic therapy without response. RESULTS: Diagnostic signs of pulmonary tuberculosis were infiltration (89%), lymphadenopathy (63%), calcification in lymph nodes (49%), pneumofibrosis (56%), focus of tuberculosis (54%), foci in lung segments (67%). Other features were as follows: adhesions, pleural effusion, coated pleura, calcified tuberculoma. Biopsy was performed to 25% of patients: in 6 patients during fibrobronchoscopy, in 3 during operation, and in 2 during pleural puncture. Fibrobronchoscopy was done in 70% of patients, and findings were as follows: mucus (31%), blood (2%), bronchial deformations (22%), edema of bronchial wall (18%), and no pathology (31%). Only 8% had acid-resistant cocci. CONCLUSIONS: Computed tomography is 2 times more efficient than roentgenography in detection of lung alterations, dissemination with focal infiltration in the bronchioles, coated pleura, pleuritis, adhesions and 8 times more efficient in diagnosis of mediastinal lymphadenopathy. In evaluation of pulmonary consolidation, there was no significance difference between diagnostic methods.