Aftermath of pulmonary tuberculosis: Computed tomography assessment

Abstract

Purpose: Pulmonary tuberculosis (PTB) has clinically significant sequelae, even after recommended treatment comple-tion. It is important to recognise these sequelae for accurate assessment of severity and treatment planning, if indicated. Material and methods: We retrospectively analysed contrast-enhanced computed tomography (CT) scans of chest of 100 patients with previous history of treated pulmonary tuberculosis, excluding those with active pulmonary dis-ease. CT findings were analysed based on parenchymal, airway, pleural, mediastinal, and vascular sequelae of PTB. Results: Parenchymal sequelae included fibrosis with architectural distortion and volume loss (90%), cavities (21%) (with aspergillomas noted in 19% of these cases), and tuberculomas (54%). Airway involvement was noted as bron-chiectasis (77%) and bronchial stenosis (4%) but none with broncholithiasis. Mediastinal sequelae included lymph node calcification (74%), fibrosing mediastinitis (1%), and pericardial tuberculosis (2%). Pleural sequelae included pleural thickening (22%), with 40.9% of these patients showing calcifications, and one patient with chronic chylous pleural effusion. Vascular sequelae included Rasmussen aneurysms (4%), enlarged bronchial arteries (3%), and systemic bronchial collaterals in 1% of our patients. Conclusions: PTB has multiple appalling sequelae, which require due attention and appropriate treatment in sympto-matic cases. Radiological evaluation forms an integral part in patient assessment and decision making.