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KMID : 0383820110710030202
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Tuberculosis and Respiratory Diseases
2011 Volume.71 No. 3 p.202 ~ p.209
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CT Radiologic Findings in Patients with Tuberculous Destroyed Lung and Correlation with Lung Function
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Chae Jin-Nyeong
Jung Chi-Young
Shim Sang-Woo
Rho Byung-Hak
Jeon Young-June
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Abstract
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Background: A tuberculous destroyed lung is sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with a tuberculous destroyed lung account for a significant portion of those with chronic lung disease in Korea. However, few reports can be found in the literature. We investigated the computed tomography (CT) findings in a tuberculous destroyed lung and the correlation with lung function.
Materials and Methods : A retrospective analysis was carried out for 44 patients who were diagnosed with a tuberculous destroyed lung at the Keimyung University Dongsan Hospital between January 2004 and December 2009.
Results: A chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%) and emphysema in 13 cases. Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. The mean number of destroyed bronchopulmonary segments was 7.7 (range, 4∼14). The most common injured segment was the apicoposterior segment of the left upper lobe (n=36, 81.8%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by a mixed (n=7) and restrictive ventilatory defect (n=5). The number of destroyed bronchopulmonary segments showed a significant negative correlation with forced vital capacity (FVC), % predicted (r=?0.379, p=0.001) and forced expiratory volume in one second (FEV1), % predicted (r= ?0.349, p=0.020). After adjustment for age and smoking status (pack-years), the number of destroyed segments also showed a significant negative correlation with FVC, % predicted (B=?0.070, p=0.014) and FEV1, % predicted (B=?0.050, p=0.022).
Conclusion: Tuberculous destroyed lungs commonly showed obstructive ventilatory defects, possibly due to bronchiectasis and emphysema. There was negative correlation between the extent of destruction and lung function.
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KEYWORD
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Tuberculosis, Pulmonary/complications, Lung Diseases, Obstructive, Tuberculosis, Bronchiectasis
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