title: Pulmonary tuberculosis: tomographic evaluation in the active and post-treatment phases.
abstract: BACKGROUND
  Adequate knowledge of images consistent with tuberculosis activity is an important resource for tuberculosis diagnosis and treatment.
  
  
  OBJECTIVE
  To evaluate the structural alterations caused by tuberculosis in the pulmonary parenchyma, both during the active phase of the disease and after the end of the treatment, through computerized tomography of the thorax.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Pulmonary Division, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo.
  
  
  METHODS
  20 patients, carriers of pulmonary tuberculosis, confirmed by Mycobacterium tuberculosis culture.
  
  
  METHODS
  Conventional tomography scans of the patients were obtained at two times: upon diagnosis and after the end of the treatment. The following were considered suggestive signs of tuberculosis activity: centrilobular nodules with segmented distribution, confluent micronodules, consolidations, thick-walled cavities, nodules, masses, thickening of the bronchial walls, tree-in-bud appearance and cylindrical bronchiectasis.
  
  
  METHODS
  The presence of suggestive signs of tuberculosis activity was compared between the start and the end of treatment by means of the signs test (z).
  
  
  RESULTS
  All patients (20/20) presented suggestive signs of tuberculosis activity at the start of treatment. After the end of treatment, 13 patients (13/20) still presented some suggestive signs consistent with activity. A reduction in the extent of lung attack was seen post-treatment, in relation to its start (z = 10.10). This change was statistically significant (p < 0.001).
  
  
  CONCLUSIONS
  Signs suggestive of tuberculosis activity are present in the active disease and are seen via computed tomography. The extent of parenchymal attack significantly decreases following treatment. Such signs may be useful in the diagnosis of pulmonary tuberculosis.
authors.affiliation: Pulmonary Division, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. sbombarda@ig.com.br
authors.forename: Sidney
authors.initials: S
authors.lastname: Bombarda
authors.forename: Cláudia Maria
authors.initials: CM
authors.lastname: Figueiredo
authors.forename: Márcia
authors.initials: M
authors.lastname: Seiscento
authors.forename: Mário
authors.initials: M
authors.lastname: Terra Filho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents