Evaluation of Pulmonary and Pleural Changes Among Tuberculosis Patients Using High-Resolution Computed Tomography in Association with TB Stage

Abstract

Background: Tuberculosis remains a major cause of respiratory morbidity, and conventional chest radiography may underestimate subtle pulmonary and pleural structural abnormalities. High-resolution computed tomography provides detailed assessment of parenchymal, airway, nodal, and pleural changes and may help characterize disease activity and chronic post-tuberculosis sequelae. Objective: To evaluate pulmonary and pleural HRCT findings among tuberculosis patients and determine their association with active and inactive tuberculosis stage. Methods: This cross-sectional observational study included 94 adult pulmonary tuberculosis patients assessed at Lahore General Hospital and Services Hospital, Lahore. HRCT findings were recorded as present or absent for tree-in-bud pattern, cavitary lesions, fibrosis, consolidation, pleural effusion, lymphadenopathy, calcified nodules, bronchiectasis, and pleural thickening. Data were analyzed using SPSS version 27.0, and associations between HRCT findings and tuberculosis stage were assessed using chi-square analysis with p < 0.05 considered statistically significant. Results: The mean age was 50.36 ± 19.83 years. Active tuberculosis was present in 60 patients (63.8%), while 34 patients (36.2%) had inactive disease. Consolidation and pleural thickening were the most frequent findings, each observed in 44 patients (46.8%). Tree-in-bud pattern, consolidation, pleural effusion, and lymphadenopathy were significantly more frequent in active tuberculosis, whereas fibrosis, calcified nodules, and pleural thickening were significantly more frequent in inactive tuberculosis. Conclusion: HRCT demonstrated distinct pulmonary and pleural patterns associated with tuberculosis stage and may support differentiation between active inflammatory disease and chronic post-tuberculosis structural sequelae