DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20170643

Role of high resolution computed tomography in the clinico- radiological study of diffuse parenchymal lung diseases and in disease progression of tuberculosis

Sumit Sharma, S. Shrinuvasan, R. Chidambaram

Abstract


Background: This study was undertaken to detect and study the various HRCT patterns of DPLD, to assess disease progression of TB, also to evaluate disease prognosis and reversibility by quantification of data and compare it with clinical and functional impairment as evaluated by PFT; and to finally correlate it with a histopathological diagnosis wherever necessary.

Methods: This prospective study was conducted in the Department of Radiodiagnosis, SLIMS from December 2014 to November 2016. Patients of all age groups (3-86 years) presenting with dyspnea at rest/exertion, dry cough and known cases of DPLD were included; known lung anomalies were excluded. Clinical history with relevant lab investigations was followed by computerized radiography and HRCT. The extent of disease on HRCT scans, assessed by the mean attenuation value of the lung, was correlated with the severity of dyspnea and PFT results. HPE was done for diagnostic confirmation.

Results: IPF including chronic interstitial pneumonia comprised the most common group of diseases accounting for 28.3% cases followed by TB (25%). ‘Tree in bud’ appearance (71.4%), consolidation (42.8%) and scattered nodules (28.5%) are features of active disease while fibrosis (50%), honeycombing (50%), traction bronchiectasis (37.5%) and calcified granuloma (37.5%) are features of inactive disease. The histogram of the relative frequency of pulmonary attenuation values was depressed and skewed to the right in most cases. There was a statistically significant positive correlation between the mean lung density and severity of dyspnea and the extent of functional impairment as measured by the reduction in DLCO. Seven cases of active TB, three of sarcoidosis, three of PSS and two each of ABPA and HP among others were biopsy proven.

Conclusions: The present study concludes that HRCT is an invaluable tool in the detection, characterization, diagnosis, and evaluation of disease prognosis and reversibility of DPLDs especially in the study of disease progression of TB, in an appropriate clinical setting; while HPE is the gold standard for confirmation of the diagnosis.

Keywords


Diffuse parenchymal lung disease, HRCT, Tuberculosis

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References


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