A high-resolution computed tomography-based scoring system to differentiate the most infectious active pulmonary tuberculosis from community-acquired pneumonia in elderly and non-elderly patients

作者：Yeh Jun Jun^*; Chen Solomon Chih Cheng; Chen Cheng Ren; Yeh Ting Chun; Lin Hsin Kai; Hong Jia Bin; Wu Bing Tsang; Wu Ming Ting

来源：European Radiology, 2014, 24(10): 2372-2384.

DOI：10.1007/s00330-014-3279-6

• High-resolution CT
• Patient isolation
• Sputum smear
• Tuberculosis

The objective of this study was to use high-resolution computed tomography (HRCT) imaging to predict the presence of smear-positive active pulmonary tuberculosis (PTB) in elderly (at least 65 years of age) and non-elderly patients (18-65 years of age). %26lt;br%26gt;Patients with active pulmonary infections seen from November 2010 through December 2011 received HRCT chest imaging, sputum smears for acid-fast bacilli and sputum cultures for Mycobacterium tuberculosis. Smear-positive PTB was defined as at least one positive sputum smear and a positive culture for M. tuberculosis. Multivariate logistic regression analyses were performed to determine the HRCT predictors of smear-positive active PTB, and a prediction score was developed on the basis of receiver operating characteristic curve analysis. %26lt;br%26gt;Of 1,255 patients included, 139 were diagnosed with smear-positive active PTB. According to ROC curve analysis, the sensitivity, specificity, positive predictive value, negative predictive value, false positive rates and false negative rates were 98.6 %, 95.8 %, 78.5 %, 99.8 %, 4.2 % and 1.4 %, respectively, for diagnosing smear-positive active PTB in elderly patients, and 100.0 %, 96.9 %, 76.5 %, 100.0 %, 3.1 % and 0.0 %, respectively, for non-elderly patients. %26lt;br%26gt;HRCT can assist in the early diagnosis of the most infectious active PTB, thereby preventing transmission and minimizing unnecessary immediate respiratory isolation. %26lt;br%26gt;aEuro cent HRCT can assist in the early diagnosis of the infectious active PTB %26lt;br%26gt;aEuro cent HRCT imaging is useful to predict the presence of smear-positive active PTB %26lt;br%26gt;aEuro cent Predictions from the HRCT imaging are valid even before sputum smear or culture results.

• 出版日期2014-10