Evaluation of Pulmonary and Pleural Changes Among Tuberculosis Patients Using High-Resolution Computed Tomography in Association with TB Stage
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Background: High-resolution computed tomography (HRCT) provides detailed characterization of pulmonary, airway, nodal, and pleural abnormalities in tuberculosis, although individual imaging findings may overlap between active disease and chronic post-tuberculosis structural change. Objective: To evaluate pulmonary and pleural HRCT findings among adults with pulmonary tuberculosis and determine their association with active versus inactive tuberculosis stage. Methods: This analytical cross-sectional study included 94 adults assessed at Lahore General Hospital and Services Hospital, Lahore. Nine predefined HRCT findings were recorded as present or absent. Associations with documented active or inactive tuberculosis stage were assessed using Pearson's chi-square test, and unadjusted odds ratios with 95% confidence intervals were derived from the supplied contingency data. Results: Sixty participants (63.8%) were classified as having active tuberculosis and 34 (36.2%) as inactive. Tree-in-bud pattern was substantially more frequent in active tuberculosis (61.7% vs 8.8%; OR 16.62, 95% CI 4.56–60.65; p<0.001). Consolidation, pleural effusion, and lymphadenopathy were also more frequent in active disease. Fibrosis (73.5% vs 23.3%; p<0.001), calcified nodules (73.5% vs 25.0%; p<0.001), and pleural thickening were more frequent in inactive tuberculosis. Cavitary lesions showed a borderline association with active disease (p=0.055), while bronchiectasis showed no stage-related association (p=0.847). Conclusion: HRCT abnormalities showed distinct associations with tuberculosis stage. HRCT may support anatomical characterization of active inflammatory patterns and chronic structural sequelae when interpreted alongside clinical and microbiological assessment. Keywords: Pulmonary Tuberculosis; High-Resolution Computed Tomography; Tree-in-Bud Pattern; Pulmonary Fibrosis; Pleural Thickening; Post-Tuberculosis Lung Disease; Cross-Sectional Studies
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