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A Comparative Study of Chest Computed Tomography Findings: 1030 Cases of Drug-Sensitive Tuberculosis versus 516 Cases of Drug-Resistant Tuberculosis

Authors Cheng N, Wu S, Luo X, Xu C, Lou Q, Zhu J, You L, Li B

Received 12 January 2021

Accepted for publication 4 March 2021

Published 18 March 2021 Volume 2021:14 Pages 1115—1128

DOI https://doi.org/10.2147/IDR.S300754

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony


Nianlan Cheng, Shuo Wu, Xianli Luo, Chunyan Xu, Qin Lou, Jin Zhu, Lu You, Bangguo Li

Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, People’s Republic of China

Correspondence: Bangguo Li
Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, People’s Republic of China
Tel +86 13511816288
Email [email protected]

Purpose: To investigate the CT features of drug-resistant pulmonary tuberculosis (DR-PTB) and the diagnostic value of CT in DR-PTB diagnosis to provide imaging evidence for the timely detection of drug-resistant Mycobacterium tuberculosis.
Materials and Methods: A total of 1546 cases of pulmonary tuberculosis (PTB) with complete clinical data, chest CT images and defined drug sensitivity testing results were consecutively enrolled; 516 cases of DR-PTB were included in the drug-resistant group, and 1030 cases of drug-sensitive pulmonary tuberculosis (DS-PTB) were included in the drug-sensitivity group. Comparative analyses of clinical symptoms and imaging findings were conducted. Univariate and logistic regression analyses were performed, a regression equation model was developed, and the receiver operating characteristic (ROC) curve was constructed.
Results: In the univariate analysis, some features, including whole-lung involvement, multiple cavities, thick-walled cavities, collapsed lung, disseminated lesions along the bronchi, bronchiectasis, emphysema, atelectasis, calcification, proliferative lesions, encapsulated effusion, etc., were observed more frequently in the DR-PTB group than in the DS-PTB group, and the differences were statistically significant (p< 0.05). Exudative lesions and pneumoconiosis were observed more frequently in the drug-sensitivity group than in the drug-resistant group (p< 0.05). Logistic regression analysis indicated that whole-lung involvement, multiple cavities, thick-walled cavities, disseminated lesions along the bronchi, bronchiectasis, and emphysema were independent risk factors for DR-PTB, and exudative diseases were protective factors. The total prediction accuracy of the regression model was 80.6%, and the area under the ROC curve (AUC) was 82.6%.
Conclusion: Chest CT manifestations of DR-PTB had certain characteristics that significantly indicated the possibility of drug resistance in tuberculosis patients, specifically when multifarious imaging findings, including multiple cavities, thick-walled cavities, disseminated lesions along the bronchi, whole-lung involvement, etc., coexisted simultaneously. These results may provide imaging evidence for timely drug resistance detection in suspected drug-resistant cases and contribute to the early diagnosis of DR-PTB.

Keywords: pulmonary tuberculosis, drug resistance, tomography, X-ray computed, imaging findings, diagnosis, Mycobacterium tuberculosis

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