title: Computed tomography in predicting smear-negative pulmonary tuberculosis in AIDS patients.
abstract: BACKGROUND
  The correct diagnosis of sputum smear-negative pulmonary tuberculosis in AIDS patients is very important to their therapy. We aimed to assess the value of the computed tomography (CT) and clinical findings in predicting smear-negative pulmonary tuberculosis in AIDS patients.
  
  
  METHODS
  A total of 121 AIDS patients suspected of smear-negative pulmonary tuberculosis by clinical and radiographic findings were recruited. Pulmonary tuberculosis was diagnosed in 57 (47.1%) patients. The CT and clinical predictors were selected to diagnose AIDS-related pulmonary tuberculosis through univariate and multivariate Logistic analysis.
  
  
  RESULTS
  Multivariate analysis showed that five variables, including weight loss, presence of miliary nodules, necrotic lymph node, lobular consolidation, tree-in-bud sign, were independent predictors of pulmonary tuberculosis in AIDS patients. Predicted scores based on the five variables were used to identify pulmonary tuberculosis. If the predicted score of 3 was taken as the ideal cut-off point in the diagnosis of AIDS-related smear-negative pulmonary tuberculosis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.2%, 81.2%, 80.0%, 85.2%, and 82.6%, respectively.
  
  
  CONCLUSIONS
  The prediction method based on five key factors of clinical and CT findings are useful in guiding the diagnosis of smear-negative pulmonary tuberculosis in AIDS patients.
authors.affiliation: Department of Radiology, Shanghai Public Health Clinic Center Affiliated to Fudan University, Shanghai 201508, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Feng
authors.forename: Yu-Xin
authors.initials: YX
authors.lastname: Shi
authors.forename: Gan-Lin
authors.initials: GL
authors.lastname: Xia
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhu
authors.forename: Hong-Zhou
authors.initials: HZ
authors.lastname: Lu
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Zhang
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000000981:diagnostic imaging*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011859:Radiography; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging*